Active NPI
Kelle Creecy White, LCSW-S
- Clinical Social Worker
- Lakeside, TX
National Provider Identifier
1821975566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 64220
- Practice address
- 108 Lakeridge Rd
Lakeside, TX 76108-9426 - Phone
- (817) 448-4475
- NPI assigned
- Aug 15, 2025
- Last updated
- Aug 15, 2025
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 64220 | TX | Primary |
Addresses
Primary practice location
108 Lakeridge Rd
Lakeside, TX 76108-9426
Mailing address
108 Lakeridge Rd
Lakeside, TX 76108-9426
Phone (817) 448-4475
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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 64220 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755216000000",
"number": "1821975566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 LAKERIDGE RD",
"city": "LAKESIDE",
"state": "TX",
"postal_code": "761089426",
"telephone_number": "817-448-4475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 LAKERIDGE RD",
"city": "LAKESIDE",
"state": "TX",
"postal_code": "761089426",
"telephone_number": "817-448-4475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "KELLE",
"middle_name": "CREECY",
"credential": "LCSW-S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-15",
"last_updated": "2025-08-15",
"certification_date": "2025-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "64220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeside, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.