Takenya White

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

Practice address

13136 Western Ave
Blue Island, IL 60406-2423

Phone

(708) 858-8946

NPI assigned

Mar 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Expressive Arts Services LLC

  dba Expressive Arts Services

  • Counselor
  • Blue Island, IL
  • NPI 1750198495
  NPD Authorized official

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

{
    "created_epoch": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1770119935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13136 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13136 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062423",
            "telephone_number": "708-858-8946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2155 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Blue Island",
            "state": "IL",
            "postal_code": "604063050",
            "country_code": "US",
            "telephone_number": "708-362-7559",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5318 135th St",
            "address_purpose": "LOCATION",
            "city": "Crestwood",
            "state": "IL",
            "postal_code": "604181504",
            "country_code": "US",
            "telephone_number": "708-362-7559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "TAKENYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twhite@eisencoop.org",
            "affiliation": "Y",
            "affiliationName": "Eisenhower Cooperative",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5318 135th St",
            "city": "Crestwood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "604181504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Toyar Walker
• Earnest Wallace
• Carol Palmer Wardlaw, RN,APN
• Julia Wegmann, MSW, LSW
• Anthony West
• Wholistic Healthcare Services, Inc.
• Barbara May Wieties-Malm, MD
• Sarah L Williams
• Shirley Vernetha Willis III, REGISTERED NURSE
• Alma Wingard

• Intellectual & Developmental Disabilities Psychologist in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Intellectual & Developmental Disabilities Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.