Individual provider Active NPI

Carl White

  • Professional Counselor
  • Rochester, MN
National Provider Identifier
1699214890
Registry record updated Feb 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
23982 Issued in MN
Practice address
1530 Assisi Dr NW
Rochester, MN 55901-1637
Phone
(507) 288-3733
Fax
(612) 333-4111
NPI assigned
Feb 21, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 23982 MN Primary

Addresses

Primary practice location

1530 Assisi Dr NW
Rochester, MN 55901-1637

Mailing address

740 E 24TH St
Minneapolis, MN 55404-3862
Phone (612) 333-3366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191023003108 MN Practitioner - Clinical Social Worker 5092047076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosewood Counseling LLCGroup PAC ID 9537550561, 2 clinicians

Practice addresses (Care Compare)

300 3Rd Ave SE
Suite 202
Rochester, MN 55904-4632
Phone (507) 722-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23982MNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Meadows Center for Mental Health Services LLC CurrentSince Sep 17, 2023 Accepting new patients
Off-Grid LLC Current Accepting new patients
Rosewood Counseling LLC CurrentSince Jul 1, 2023 Accepting new patients

Locations

3737 40th Ave NW
Rochester, MN 55901
Phone (507) 288-6978

300 3rd Ave SE
Ste 202
Rochester, MN 55904
Phone (507) 722-1900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1699214890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 E 24TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043862",
            "telephone_number": "612-333-3366",
            "fax_number": "612-333-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 ASSISI DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011637",
            "telephone_number": "507-288-3733",
            "fax_number": "612-333-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CARL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-21",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "23982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

Verify at the official NPI Registry.