William R White Counseling & Psychotherapy PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

149.004861 Issued in IL

Legal business name

WILLIAM R WHITE COUNSELING & PSYCHOTHERAPY PC

Practice address

712 E Empire St
Bloomington, IL 61701-3252

Phone

(309) 287-9464

Fax

(309) 827-7576

NPI assigned

Mar 17, 2011

Organization subpart

No

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

Authorized official

Name

William R White, LCSWNPI 1356521280

Title

President

Phone

(309) 287-9464

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 3

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

• William Roger White, LCSW

  • Clinical Social Worker
  • Bloomington, IL
  • NPI 1356521280
  Medicare reassignment NPD Authorized official
• Felicitas Sarmiento Sebastian, PHD

  • Clinical Psychologist
  • Bloomington, IL
  • NPI 1891887261
  NPD (past)
• Kay B. White, LCSW

  • Clinical Social Worker
  • Bloomington, IL
  • NPI 1417493644
  NPD (past)

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

{
    "created_epoch": "1300320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300320000000",
    "number": "1447559356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 E EMPIRE ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013252",
            "telephone_number": "309-287-9464",
            "fax_number": "309-827-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 E EMPIRE ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617013252",
            "telephone_number": "309-287-9464",
            "fax_number": "309-827-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM R WHITE COUNSELING & PSYCHOTHERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-17",
        "last_updated": "2011-03-17",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-287-9464",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "IL",
            "license": "149.004861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Don P Willard, MS, PT, ATC
• Alexander Perry Willett, PSYD
• Paul D Willett, PH.D.
• Bryne Paul Willey, D.C., M.S.
• William B. Witte, LTD
• Williams Psychological Services PLLC
• Bonnie Williams
• Cedric Williams, PHD
• Diane Kay Williams, MHS, CADC
• Jefferson Williams, LCPC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2011; 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.