Individual provider Active NPI

Joseph White

  • Mental Health Counselor
  • Mechanicsville, VA
National Provider Identifier
1982195012
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3241 Issued in VA
Practice address
8104 Elm Dr Ste a
Mechanicsville, VA 23111-1106
Phone
(804) 585-6016
NPI assigned
May 24, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 3241 VA Primary

Addresses

Primary practice location

8104 Elm Dr Ste a
Mechanicsville, VA 23111-1106

Mailing address

6407 Bareback Ter
North Chesterfield, VA 23234-4196
Phone (804) 585-4988

Other practice location 1

6407 Bareback Ter
North Chesterfield, VA 23234-4196
Phone (804) 585-6016

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL crystallewis@edacllc.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3241VAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Edacllc Mental Health CurrentSince Nov 8, 2020 Accepting new patients

Locations

8104 Elm Dr
#A
Mechanicsville, VA 23111
Phone (804) 585-4988

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1527120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1982195012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6407 BAREBACK TER",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232344196",
            "telephone_number": "804-585-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8104 ELM DR STE A",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231111106",
            "telephone_number": "804-585-6016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6407 Bareback Ter",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232344196",
            "country_code": "US",
            "telephone_number": "804-585-6016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JOSEPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-24",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "3241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "crystallewis@edacllc.org",
            "affiliation": "N",
            "address_1": "8104 Elm Dr Ste A",
            "city": "Mechanicsville",
            "state": "VA",
            "country_code": "US",
            "postal_code": "231111106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.