Nichole White, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

P-0397 Issued in WV

Practice address

415 Benedum Dr
Bridgeport, WV 26330-1503

Phone

(304) 842-9887

Fax

(304) 842-9888

NPI assigned

Mar 23, 2007

Reactivated

Jan 16, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

WV Therapy Services LLCGroup PAC ID 8123106416, 26 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• WV Therapy Services LLC

  • Specialist
  • Bridgeport, WV
  • NPI 1063692333
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1912024050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 RUMER STA",
            "city": "RED HOUSE",
            "state": "WV",
            "postal_code": "251686803",
            "telephone_number": "304-545-7988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BENEDUM DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301503",
            "telephone_number": "304-842-9887",
            "fax_number": "304-842-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "NICHOLE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-23",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "deactivation_date": "2007-07-17",
        "reactivation_date": "2015-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WV",
            "license": "P-0397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lee Wetzel, MA
• White Oaks Assisted Living
• Damien Hunter White, DC
• Danielle White
• Lisa White
• Levi Dean Wichterman, NP-C
• Mary Wichterman, APRN
• Jessica Marie Willard, PRSS
• Destiny D Williams, FNP-BC
• Junemarie Williams, APRN-FNP-BC

• Speech-Language Pathologist in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Speech-Language Pathologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.