MEDICARE: MRS. JESSICA LYNNE WHITE MSW, LCSW, RYT 200

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
1	1041C0700X	Clinical Social Worker	C014919	NC

General Provider Information

NPI Number	:	1316212335
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA LYNNE WHITE MSW, LCSW, RYT 200

Provider Business Mailing Address
First Line	:	214B N TOPSAIL DR
Second Line	:
City	:	SURF CITY
State	:	NC
Zip	:	28445-6720
Country	:	US
Telephone Number	:	703-477-3782
Fax Number	:

Provider Business Practice Location Address
First Line	:	214B N TOPSAIL DR
Second Line	:
City	:	SURF CITY
State	:	NC
Zip	:	28445-6720
Country	:	US
Telephone Number	:	703-477-3782
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2012
Last Update Date	:	08/04/2022

Similar Medicare Providers

1508859034 — DAVID ALAN DEITZ PT, DPT, OCS
Practice Location Address:

107 TRITON LN
SURF CITY, NC
28445-6923

Practice Phone: 910-803-2040
Practice Fax: 910-803-2050

1326564287 — PROVIDENCE PHYSICAL THERAPY, LLC
Practice Location Address:

107 TRITON LN
SURF CITY, NC
28445-6923

Practice Phone: 910-803-2040
Practice Fax: 910-803-2050

1184896946 — TINA FORTIER PT
Practice Location Address:

107 TRITON LN
SURF CITY, NC
28445-6923

Practice Phone: 910-803-2040
Practice Fax: 910-803-2050

1366877870 — MRS. KEELY PETERSON BROWN PT
Practice Location Address:

107 TRITON LN
SURF CITY, NC
28445-6923

Practice Phone: 910-803-2040
Practice Fax: 910-803-2050

1902885700 — DR. JAMES S BLAIR III MD
Practice Location Address:

13567 NC HIGHWAY 50
SURF CITY, NC
28445-6555

Practice Phone: 910-329-9916
Practice Fax: 910-329-9919

1669426946 — VONDA B GARDNER MSW, LCSW
Practice Location Address:

743 COCKLE ST
SURF CITY, NC
28445-6511

Practice Phone: 910-231-1986
Practice Fax:

Directions to “ MRS. JESSICA LYNNE WHITE MSW, LCSW, RYT 200” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.