Organization Active NPI

Jason K. White, PH.D., LLC

  • Counseling Psychologist
  • Stillwater, OK
National Provider Identifier
1366090680
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
JASON K. WHITE, PH.D., LLC
Practice address
807 S. Pine St.
Stillwater, OK 74074
Phone
(405) 614-2846
Fax
(405) 533-2888
NPI assigned
Aug 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jason Kent White, PH.D.NPI 1144240383
Title
Psychologist
Phone
(405) 614-2846

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

807 S. Pine St.
Stillwater, OK 74074

Mailing address

807 S. Pine St.
Stillwater, OK 74074
Phone (405) 614-2846

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200122000911 OK Part B Supplier - Clinic/Group Practice 6305271305 Receives reassigned benefits from 1 practitioner
Practice locations: Stillwater, OK

National Provider Directory

National Provider Directory

Locations

807 S Pine St
#K
Stillwater, OK 74074
Phone (405) 614-2846

807 S Pine St
Stillwater, OK 74074
Phone (405) 533-3888

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567036800000",
    "number": "1366090680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 S. PINE ST.",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "74074",
            "telephone_number": "405-614-2846",
            "fax_number": "405-533-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 S. PINE ST.",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "74074",
            "telephone_number": "405-614-2846",
            "fax_number": "405-533-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON K. WHITE, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-29",
        "last_updated": "2019-08-29",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "405-614-2846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.