G Zachariah White, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5211 Issued in MN

Practice address

2375 University Ave W Ste 160
Saint Paul, MN 55114-1632

Phone

(612) 208-9739

Fax

(612) 643-3479

NPI assigned

Nov 11, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mr. Gary Zachariah White Former name

Medicare fee-for-service enrollment

Enrolled in MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• GZW Psych PLLC

  • Clinical Psychologist
  • Saint Paul, MN
  • NPI 1558834267
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702080000000",
    "number": "1790012771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 UNIVERSITY AVE W STE 160",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141632",
            "telephone_number": "612-208-9739",
            "fax_number": "612-643-3479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 UNIVERSITY AVE W STE 160",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141632",
            "telephone_number": "612-208-9739",
            "fax_number": "612-643-3479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "G",
        "middle_name": "ZACHARIAH",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-11-11",
        "last_updated": "2023-12-09",
        "certification_date": "2023-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5211",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GARY",
            "last_name": "WHITE",
            "middle_name": "ZACHARIAH",
            "prefix": "MR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alanna Jane Whelan, APRN, CRNA
• Timothy Meyer Whisler
• Holly S Whitaker, MA, LPCC
• Cara Brienne White, LICSW
• Cortney D White, M.D.
• Helen White, MPS
• James Robert White, M.D.
• Jon-Ano A White, MD
• Kimberly Ann White, M.A., LICSW
• Mary Susan White, LPCC

• Clinical Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.