Active NPI
De'Audra Jackson Whiting, LCDC
- Addiction (Substance Use Disorder) Counselor
- Magnolia, TX
National Provider Identifier
1649558602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 9347
- Practice address
- 402 Sagebrush LN
Magnolia, TX 77354-1736 - Phone
- (832) 659-1224
- NPI assigned
- Jul 25, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 9347 | TX | Primary |
Addresses
Primary practice location
402 Sagebrush LN
Magnolia, TX 77354-1736
Mailing address
402 Sagebrush LN
Magnolia, TX 77354-1736
Phone (832) 659-1224
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9347 | Other | TX | LICENSED CHEMICAL DEPENDENCY COUNSELOR |
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 |
|---|---|---|---|
| 9347 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311552000000",
"number": "1649558602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 SAGEBRUSH LN",
"city": "MAGNOLIA",
"state": "TX",
"postal_code": "773541736",
"telephone_number": "832-659-1224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 SAGEBRUSH LN",
"city": "MAGNOLIA",
"state": "TX",
"postal_code": "773541736",
"telephone_number": "832-659-1224"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITING",
"first_name": "DE'AUDRA",
"middle_name": "JACKSON",
"name_prefix": "Ms.",
"credential": "LCDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-25",
"last_updated": "2011-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "9347",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSED CHEMICAL DEPENDENCY COUNSELOR",
"identifier": "9347",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Magnolia, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.