Individual provider Active NPI

William Jerry White Jr., LMSW

  • Clinical Social Worker
  • Ann Arbor, MI
National Provider Identifier
1558694042
Registry record updated Mar 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801046207 Issued in MI
Practice address
2750 S State St
Ann Arbor, MI 48104-6179
Phone
(734) 662-6300
Fax
(734) 662-3365
NPI assigned
Sep 15, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801046207 MI Primary

Addresses

Primary practice location

2750 S State St
Ann Arbor, MI 48104-6179

Mailing address

2723 S State St Ste 150
Ann Arbor, MI 48104-6188
Phone (734) 646-1086

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801046207MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1558694042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2723 S STATE ST STE 150",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046188",
            "telephone_number": "734-646-1086",
            "fax_number": "734-761-3884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481046179",
            "telephone_number": "734-662-6300",
            "fax_number": "734-662-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "WILLIAM",
        "middle_name": "JERRY",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-15",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801046207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; 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.