Susan White

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

584 Issued in KS

Legal business name

SUSAN WHITE

Doing business as

Eagle Recovery Services & Consultation

Practice address

5 S Peoria St
Suite 206
Louisburg, KS 66053-4084

Phone

(913) 837-4919

Fax

(913) 837-4923

NPI assigned

Apr 15, 2007

Last updated

Jun 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Susan Gayle White, LMSW, CADCIII

Title

Executive Director

Phone

(913) 837-4919

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eagle Recovery Services & Consultation Doing business as

Locations

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

{
    "created_epoch": "1176595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1750506945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 S PEORIA ST",
            "address_2": "SUITE 206",
            "city": "LOUISBURG",
            "state": "KS",
            "postal_code": "660534084",
            "telephone_number": "913-837-4919",
            "fax_number": "913-837-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 S PEORIA ST",
            "address_2": "SUITE 206",
            "city": "LOUISBURG",
            "state": "KS",
            "postal_code": "660534084",
            "telephone_number": "913-837-4919",
            "fax_number": "913-837-4923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN WHITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-15",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "GAYLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "913-837-4919",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSW, CADCIII"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200305900A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eagle Recovery Services & Consultation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in Louisburg, KS
• Providers in Louisburg, KS by specialty
• Addiction (Substance Use Disorder) Counselor in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.