SP White Psychological Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

SP WHITE PSYCHOLOGICAL SERVICES, LLC

Practice address

Teletherapy - Need Address Private -
Toms River, NJ 08753-2064

Phone

(732) 573-4282

NPI assigned

Apr 7, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Susan Polkowski White, PSYDNPI 1043853161

Title

Psychologist

Phone

(732) 573-4282

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Susan Polkowski White, PSYD

  • Psychologist
  • Toms River, NJ
  • NPI 1043853161
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1811526288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 ESTATE POINT RD",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087532064",
            "telephone_number": "732-573-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TELETHERAPY - NEED ADDRESS PRIVATE -",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087532064",
            "telephone_number": "732-573-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SP WHITE PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "POLKOWSKI",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "732-573-4282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.