Organization Active NPI

Kwhite Counseling, LLC

  • Community/Behavioral Health Agency
  • Longwood, FL
National Provider Identifier
1750644084
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
SW6487 Issued in FL
Legal business name
KWHITE COUNSELING, LLC
Practice address
1385 W State Road 434
Longwood, FL 32750-6871
Phone
(407) 247-5972
Fax
(407) 960-3686
NPI assigned
Jun 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Ms. Katharine W. Mendoza, LCSWNPI 1447519889
Title
Manager
Phone
(407) 247-5972

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
Community/Behavioral Health Agency 251S00000X SW6487 FL Primary

Addresses

Primary practice location

1385 W State Road 434
Longwood, FL 32750-6871

Mailing address

1385 W State Road 434
Suite 207
Longwood, FL 32750-6871
Phone (407) 247-5972

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140425001445 FL Part B Supplier - Clinic/Group Practice 0840423992 Receives reassigned benefits from 1 practitioner
Practice locations: Longwood, FL

National Provider Directory

National Provider Directory

Locations

1385 W State Road 434
Longwood, FL 32750
Phone (407) 247-5972

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1750644084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1385 W STATE ROAD 434",
            "address_2": "SUITE 207",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506871",
            "telephone_number": "407-247-5972",
            "fax_number": "407-960-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 W STATE ROAD 434",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327506871",
            "telephone_number": "407-247-5972",
            "fax_number": "407-960-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KWHITE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-21",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "MENDOZA",
        "authorized_official_first_name": "KATHARINE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-247-5972",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "SW6487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.