Healthcare Provider Details

I. General information

NPI: 1659008340
Provider Name (Legal Business Name): NATALIE MARIE WHITE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2022
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8530 KENTFORD DR
SPRINGFIELD VA
22152-3243
US

IV. Provider business mailing address

4456 LOGAN DR NE
LACEY WA
98516-1351
US

V. Phone/Fax

Practice location:
  • Phone: 703-786-8464
  • Fax:
Mailing address:
  • Phone: 703-786-8464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904017463
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: