NPIMap

Organization Active NPI

Lola White PSYD LLC

  • Clinical Psychologist
  • Salem, OR
National Provider Identifier
1871114793
Registry record updated May 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
LOLA WHITE PSYD LLC
Practice address
388 State St Ste 704
Salem, OR 97301-4023
Phone
(503) 917-9623
NPI assigned
May 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2020

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

Authorized official

Name
Dr. Laura White, PSYDNPI 1306275847
Title
Owner
Phone
(503) 917-9623

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

388 State St Ste 704
Salem, OR 97301-4023

Mailing address

388 State St Ste 704
Salem, OR 97301-4023
Phone (503) 917-9623

National Provider Directory

National Provider Directory

Locations

388 State St
Ste 704
Salem, OR 97301
Phone (503) 917-9623

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588291200000",
    "number": "1871114793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 STATE ST STE 704",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014023",
            "telephone_number": "503-917-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "388 STATE ST STE 704",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014023",
            "telephone_number": "503-917-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOLA WHITE PSYD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-05-01",
        "certification_date": "2020-05-01",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-917-9623",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.