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NPI Code Detail

MEDICARE: MALORI WHITE-JEFFERSON

MEDICARE: MALORI WHITE-JEFFERSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC019918NC

General Provider Information

NPI Number : 1225775711
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALORI WHITE-JEFFERSON
Provider Business Mailing Address
First Line : 3609 UNION ST
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-7057
Country : US
Telephone Number : 195-197-2549
Fax Number :
Provider Business Practice Location Address
First Line : 711 ROANOKE AVE
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-5643
Country : US
Telephone Number : 252-338-4370
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2022
Last Update Date : 06/09/2026

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Directions to “ MALORI WHITE-JEFFERSON ” Practice Location

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