Krystina M. White, Licsw, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

KRYSTINA M. WHITE, LICSW, LLC

Practice address

11 Hughes Rd Ste 202
Madison, AL 35758-3037

Phone

(256) 694-3856

NPI assigned

Nov 10, 2022

Last updated

Sep 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Krystina White, LICSWNPI 1003287764

Title

Owner

Phone

(256) 975-1023

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Krystina McAllister White, MSW, LICSW

  • Clinical Social Worker
  • Madison, AL
  • NPI 1003287764
  NPD Authorized official
• Kasey L West, LICSW

  • Clinical Social Worker
  • Madison, AL
  • NPI 1770878175
  NPD

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1659089365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23884 WALES ST",
            "city": "ELKMONT",
            "state": "AL",
            "postal_code": "356203857",
            "telephone_number": "256-975-1023",
            "fax_number": "256-910-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 HUGHES RD STE 202",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357583037",
            "telephone_number": "256-694-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRYSTINA M. WHITE, LICSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-10",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "KRYSTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-975-1023",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Madison, AL
• Providers in Madison, AL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.