Kelly White, PHD, LPC, CCTP

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

37PC00776700 Issued in NJ

Practice address

44 Cooper St Ste 109
Woodbury, NJ 08096-4642

Phone

(856) 404-2248

Fax

(856) 494-1345

NPI assigned

Jan 30, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Dilks and White Counseling, Assessment, and Consulting Services

  • Mental Health Counselor
  • Turnersville, NJ
  • NPI 1902731771

  Professional

  NPD Authorized official
• Kaizen Foundation, LLC

  • Community/Behavioral Health Agency
  • Woodbury, NJ
  • NPI 1629744057
  NPD Authorized official

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1710518493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 COOPER ST STE 109",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080964642",
            "telephone_number": "856-404-2248",
            "fax_number": "856-494-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 COOPER ST STE 109",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080964642",
            "telephone_number": "856-404-2248",
            "fax_number": "856-494-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC, CCTP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37AC00466000",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00776700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Wehner, DPT
• Brett Michael Weinstock, M.D.
• Michael West, PHARMD
• Westville Public School
• Julia Lynne White, COUNSELOR
• Rona Whitehead
• Markus Whitley, MD
• Lauren Brooke Willis, LCADC
• Colleen Wills, DPT
• Julia Wilson, LAC

• Professional Counselor in Woodbury, NJ
• Providers in Woodbury, NJ by specialty
• Professional Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.