Active NPI
Richard Lamar White Jr., LSW
- Social Worker
- South Bend, IN
National Provider Identifier
1508675067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 33012504A
- Practice address
- 611 Lincoln Way E
South Bend, IN 46601-3212 - Phone
- (574) 360-4066
- NPI assigned
- Dec 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 33012504A | IN | Primary |
Addresses
Primary practice location
611 Lincoln Way E
South Bend, IN 46601-3212
Mailing address
5018 Scenic Dr
South Bend, IN 46619-2411
Phone (574) 904-0021
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
| License | State | Type | Specialty |
|---|---|---|---|
| 33012504A | IN | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1735516800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1735516800000",
"number": "1508675067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5018 SCENIC DR",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466192411",
"telephone_number": "574-904-0021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "611 LINCOLN WAY E",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466013212",
"telephone_number": "574-360-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "RICHARD",
"middle_name": "LAMAR",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-30",
"last_updated": "2024-12-30",
"certification_date": "2024-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IN",
"license": "33012504A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.