Kimberly Ann White, M.A., LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10611 Issued in MN

Practice address

1919 University Ave W
Saint Paul, MN 55104-3453

Phone

(651) 266-7901

Fax

(651) 266-7854

NPI assigned

Dec 28, 2006

Last updated

Jul 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1558427369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 UNIVERSITY AVE W STE 200",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043435",
            "telephone_number": "651-266-7901",
            "fax_number": "651-266-7854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 UNIVERSITY AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551043453",
            "telephone_number": "651-266-7901",
            "fax_number": "651-266-7854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "M.A., LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "10611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "896484000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cortney D White, M.D.
• G Zachariah White, PSYD
• Helen White, MPS
• James Robert White, M.D.
• Jon-Ano A White, MD
• Mary Susan White, LPCC
• Mary T White
• McKenzie White, MD
• Rebecca Sarah White, MA, LP
• Stirling White

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.