Anissa White, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-17343 Issued in AZ

Practice address

3316 Bemiss Rd
Valdosta, GA 31605-7014

Phone

(229) 262-7333

Fax

(229) 262-7335

NPI assigned

Aug 9, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Paris C Shields LLC

  • Clinical Social Worker
  • Valdosta, GA
  • NPI 1417300690
  NPD (past)
• Casa de Los Ninos

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1730681685
  NPD (past)
• Casa de Los Ninos, Inc.

  • Community/Behavioral Health Agency
  • Tucson, AZ
  • NPI 1760154181
  NPD (past)

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1477032563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 KNIGHTS MILL DR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316056582",
            "telephone_number": "518-569-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3316 BEMISS RD",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316057014",
            "telephone_number": "229-262-7333",
            "fax_number": "229-262-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ANISSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006873",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-17343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA BOARD OF PROFESSIONAL COUNSELORS, SOCIAL WORKERS AND MARRIAGE & FAMILY THERAP",
            "identifier": "CSW006873",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ STATE BOARD OF BEHAVIORAL HEALTH EXAMINERS",
            "identifier": "LCSW-17343",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vicki Wetter, NP-C
• Jill Whatley, PTA
• Colby Wheeler
• Lathaca Denise Wheeler, DOULA
• William Brantley Wheeler, LCSW
• Jessica Judith White, DO
• Vanessa Nichole White
• Calvin Douglas Whitehead, LCSW
• Emily Whitworth
• Maria De Los Angeles Whyte, NP

• Clinical Social Worker in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.