Individual provider Active NPI

Keandra Sharquese White, LPC-A

  • Professional Counselor
  • Forney, TX
National Provider Identifier
1407645344
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
96673 Issued in TX
Practice address
1712 Gracehill Way
Forney, TX 75126-4287
Phone
(817) 913-9360
Fax
(817) 913-9360
NPI assigned
May 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 96673 TX Primary

Addresses

Primary practice location

1712 Gracehill Way
Forney, TX 75126-4287

Mailing address

1712 Gracehill Way
Forney, TX 75126-4287
Phone (817) 913-9360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
96673TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1407645344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 GRACEHILL WAY",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751264287",
            "telephone_number": "817-913-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 GRACEHILL WAY",
            "city": "FORNEY",
            "state": "TX",
            "postal_code": "751264287",
            "telephone_number": "817-913-9360",
            "fax_number": "817-913-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KEANDRA",
        "middle_name": "SHARQUESE",
        "name_prefix": "Ms.",
        "credential": "LPC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-05-06",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "96673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forney, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.