Mundrae Dallas White, LCADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LCA2225 Issued in MD

Practice address

3218 Mayfair Rd
Baltimore, MD 21207-4561

Phone

(410) 725-8611

NPI assigned

Feb 29, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1669832028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3218 MAYFAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212074561",
            "telephone_number": "410-725-8611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3218 MAYFAIR RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212074561",
            "telephone_number": "410-725-8611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MUNDRAE",
        "middle_name": "DALLAS",
        "credential": "LCADC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "LCA2225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Janine White, M.D.
• Maxwell Tucker White
• Michael A White, DDS
• Michele Marie Mattson White, LCPC, LCADC
• Morgan White
• Nakesha R White
• Natalia Angelique White
• Naya Deneen White
• Neona White
• Richard White, MD

• Addiction (Substance Use Disorder) Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Addiction (Substance Use Disorder) Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.