Beverly White

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS016618 Issued in PA

Practice address

1055 E Baltimore Pike
Suite 300
Media, PA 19063-5173

Phone

(610) 892-3800

Fax

(484) 468-1412

NPI assigned

Feb 11, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of Connecticut PCGroup PAC ID 9436502879, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: beverly.white.1@28623.direct.athenahealth.com

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.

• Optum Behavioral Care of Connecticut, P.C.

  • Counseling Psychologist
  • Philadelphia, PA
  • NPI 1811778988

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Center for Integrative Psychotherapy PC

  • Clinical Psychologist
  • Allentown, PA
  • NPI 1962461236
  Medicare reassignment NPD
• Springfield Psychological PC

  • Mental Health Counselor
  • Springfield, PA
  • NPI 1295705317

  Multi-Specialty

  NPD
• Optum Behavioral Care of Connecticut, P.C.

  • Clinical Social Worker
  • Providence, RI
  • NPI 1730972944
  NPD

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

{
    "created_epoch": "1234310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399852800000",
    "number": "1952540221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 E BALTIMORE PIKE",
            "address_2": "SUITE 300",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635173",
            "telephone_number": "610-892-3800",
            "fax_number": "484-468-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 E BALTIMORE PIKE",
            "address_2": "SUITE 300",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635173",
            "telephone_number": "610-892-3800",
            "fax_number": "484-468-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BEVERLY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-11",
        "last_updated": "2014-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW014716",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "PA",
            "license": "PS016618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Meredith Wertheimer, DMD
• Marc J Wertheimer, MD
• Marilyn P. West-Nulty, L.P.C.
• Meredith West, PMHNP-BC
• Courtney Sheehan Wetzel, PHYSICIAN ASSISTANT
• Frank J. White, M.D.
• Margaret Mary White, LCSW
• Michela Nichole White, CNM
• Taylor Whitehead
• Christopher L Wilds, P.T.

• Clinical Psychologist in Media, PA
• Providers in Media, PA by specialty
• Clinical Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.
• 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.