Jennifer Nell White, MA LP LADC
Individual provider Active NPI Psychologist · Braham, MN
NPI 1679612782 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1679612782
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- LP2814 (MN)
- Practice address
- Five County Mental Health Center
521 Broadway Avenue North
Braham, MN 55006 - Phone
- (320) 396-3333
- Fax
- (320) 396-3363
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Five County Mental Health Center | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP2814 | MN | Yes |
Addresses
Primary practice location
Five County Mental Health Center
521 Broadway Avenue North
Braham, MN 55006
Mailing address
Five County Mental Health Center
521 Broadway Avenue North PO Box 287
Braham, MN 55006
Phone (320) 396-3333
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4H134WH | Other | BCBS | |
| 16961 | Other | OPTUM | |
| 6212389 | Other | UBH | |
| 1026277 | Other | PREFERRED ONE | |
| HP24380 | Other | HEALTHPARTNERS |
Other names
- Mrs. Jennifer Nell Shrode
Other providers in Braham, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.