Healthcare Provider Details

I. General information

NPI: 1730076308
Provider Name (Legal Business Name): MEGAN WHITE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 FERN CT
FREDERICKSBURG VA
22408-1527
US

IV. Provider business mailing address

10408 COURTHOUSE RD # 1070
SPOTSYLVANIA VA
22553-1712
US

V. Phone/Fax

Practice location:
  • Phone: 804-596-2809
  • Fax:
Mailing address:
  • Phone: 804-596-2809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904018525
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: