Active NPI
Susan Deborah White, LCPC
- Mental Health Counselor
- Bowie, MD
National Provider Identifier
1689626640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LC0769
- Practice address
- 3060 Mitchellville Rd
Suite 104
Bowie, MD 20716-1389 - Phone
- (240) 475-2221
- Fax
- (301) 384-8876
- NPI assigned
- May 17, 2006
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LC0769 | MD | Primary |
Addresses
Primary practice location
3060 Mitchellville Rd
Suite 104
Bowie, MD 20716-1389
Mailing address
12900 Tourmaline Ter
Silver Spring, MD 20904-5349
Phone (301) 384-8876
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562760 | Other | MD | MAMSI/UNITED HEALTHCARE |
| 2178897 | Other | MD | CIGNA EAP |
| 2178897 | Other | MD | CIGNA BH |
| 514031 | Other | MD | VALUEOPTIONS |
| GQ40CO | Other | MD | BC/BS CAREFIRST MD |
| 61672002 | Other | MD | CAREFIRST MD RENDERING |
| M3280003 | Other | MD | BC/BS CAREFIRST NATL CAP |
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 |
|---|---|---|---|
| LC0769 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689626640",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12900 TOURMALINE TER",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209045349",
"telephone_number": "301-384-8876",
"fax_number": "301-249-8776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3060 MITCHELLVILLE RD",
"address_2": "SUITE 104",
"city": "BOWIE",
"state": "MD",
"postal_code": "207161389",
"telephone_number": "240-475-2221",
"fax_number": "301-384-8876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "SUSAN",
"middle_name": "DEBORAH",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LC0769",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI/UNITED HEALTHCARE",
"identifier": "562760",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA EAP",
"identifier": "2178897",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BH",
"identifier": "2178897",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUEOPTIONS",
"identifier": "514031",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS CAREFIRST MD",
"identifier": "GQ40CO",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD RENDERING",
"identifier": "61672002",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS CAREFIRST NATL CAP",
"identifier": "M3280003",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.