NPIMap

Organization Active NPI

White Oak Counseling, LLC

  • Clinical Social Worker
  • Hannibal, MO
National Provider Identifier
1750586103
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2004013377 Issued in MO
Legal business name
WHITE OAK COUNSELING, LLC
Practice address
1221 Broadway
Hannibal, MO 63401-4005
Phone
(573) 221-2111
Fax
(573) 221-2123
NPI assigned
Jun 17, 2007
Last updated
Jun 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Authorized official

Name
Mrs. Carrie Danner, MSW, LCSWNPI 1215024781
Title
Owner
Phone
(573) 221-2111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 2004013377 MO Primary

Addresses

Primary practice location

1221 Broadway
Hannibal, MO 63401-4005

Mailing address

10299 Tanglewood LN
Hannibal, MO 63401-7453
Phone (573) 221-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071213000761 MO Part B Supplier - Clinic/Group Practice 3173613163 Receives reassigned benefits from 7 practitioners
Practice locations: Hannibal, MO

National Provider Directory

National Provider Directory

Locations

1221 Broadway
Hannibal, MO 63401
Phone (573) 221-2111

215 S Main St
Memphis, MO 63555
Phone (660) 465-4585

107 E Lafayette St
Monticello, MO 63457
Phone (573) 221-2111

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1182038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625011200000",
    "number": "1750586103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10299 TANGLEWOOD LN",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634017453",
            "telephone_number": "573-221-2111",
            "fax_number": "573-221-2123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 BROADWAY",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634014005",
            "telephone_number": "573-221-2111",
            "fax_number": "573-221-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE OAK COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-17",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "DANNER",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-221-2111",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2004013377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.