Individual provider Active NPI

Stephanie White

  • Counselor
  • Montgomery, TX
National Provider Identifier
1801608419
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
95710 Issued in TX
Practice address
14855 Liberty St
Montgomery, TX 77356-4631
Phone
(936) 297-5252
NPI assigned
Jan 21, 2025
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 95710 TX Primary

Addresses

Primary practice location

14855 Liberty St
Montgomery, TX 77356-4631

Mailing address

14855 Liberty St
Montgomery, TX 77356-4631
Phone (936) 297-5252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
95710TXMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Watershed Counseling Center LLC Counselor CurrentSince Jan 26, 2025 Accepting new patients

Locations

14855 Liberty St
Montgomery, TX 77356
Phone (936) 297-5252

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1737417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1801608419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14855 LIBERTY ST",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773564631",
            "telephone_number": "936-297-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14855 LIBERTY ST",
            "city": "MONTGOMERY",
            "state": "TX",
            "postal_code": "773564631",
            "telephone_number": "936-297-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "STEPHANIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-21",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "95710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, TX

Sources for this page

Verify at the official NPI Registry.