Individual provider Active NPI

Nytisha Lashea White

  • Clinical Social Worker
  • Anderson, IN
National Provider Identifier
1487617130
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005034A Issued in IN
Practice address
2519 Running Stream CT
Anderson, IN 46011-4769
Phone
(702) 237-8063
NPI assigned
Apr 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 5341-C NV
Clinical Social Worker 1041C0700X 34005034A IN Primary

Addresses

Primary practice location

2519 Running Stream CT
Anderson, IN 46011-4769

Mailing address

2519 Running Stream CT
Anderson, IN 46011-4769
Phone (765) 274-1464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240613003564 IN Practitioner - Clinical Social Worker 5294870374 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Health Network IncGroup PAC ID 1850203977, 95 clinicians

Practice addresses (Care Compare)

7165 Clearvista Way
Gallahue Mental Health Services
Indianapolis, IN 46256-4621
Phone (317) 621-5100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5341-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Community Health Network, Inc Current Accepting new patients
Community Health Network, Inc CurrentSince Oct 9, 2025 Accepting new patients
Lifeline Medical Center Mental Health CurrentSince Aug 28, 2025 Accepting new patients
Urban Social Services Corp Clinical Past Accepting new patients
Maria K Nwokikemd Face PC PastSince Mar 18, 2021 Accepting new patients

Locations

2101 Jackson St
Ste 109
Anderson, IN 46016
Phone (503) 270-3776

7165 Clearvista Way
Indianapolis, IN 46256
Phone (317) 621-5100

6950 Hillsdale Ct
Indianapolis, IN 46250
Phone (317) 621-7533

333 N Alabama St
Indianapolis, IN 46204
Phone (317) 395-3391

3310 W Fox Ridge Ln
Ste A
Muncie, IN 47304

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/20067/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1487617130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2519 RUNNING STREAM CT",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460114769",
            "telephone_number": "765-274-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2519 RUNNING STREAM CT",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460114769",
            "telephone_number": "702-237-8063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "NYTISHA",
        "middle_name": "LASHEA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-11",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "5341-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005034A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, IN

Sources for this page

Verify at the official NPI Registry.