Active NPI
Renee L White, LCSW
- Mental Health Counselor
- Kingman, AZ
National Provider Identifier
1801927991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LCSW10131
- Practice address
- 1565 Northern Ave
#3
Kingman, AZ 86409-2481 - Phone
- (928) 757-8589
- Fax
- (928) 757-0744
- NPI assigned
- Mar 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCSW10131 | AZ | Primary |
Addresses
Primary practice location
1565 Northern Ave
#3
Kingman, AZ 86409-2481
Mailing address
1565 Northern Ave
#3
Kingman, AZ 86409-2481
Phone (928) 757-8589
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113485 | Other | AZ | VALUE OPTIONS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW10131 | AZ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware County | Past | Accepting new patients | |
| Delaware County | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Public Health or Welfare Agency
- Delhi, NY
- NPI 1154689495
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Walton, NY
- NPI 1740375385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801927991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1565 NORTHERN AVE",
"address_2": "#3",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864092481",
"telephone_number": "928-757-8589",
"fax_number": "928-757-0744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1565 NORTHERN AVE",
"address_2": "#3",
"city": "KINGMAN",
"state": "AZ",
"postal_code": "864092481",
"telephone_number": "928-757-8589",
"fax_number": "928-757-0744"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "RENEE",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LCSW10131",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "113485",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kingman, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.