Provider Demographics
NPI:1316067168
Name:WHITE, SARAH (LCSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:
Other - Last Name:DAVIDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 10414
Mailing Address - Street 2:C O PARADIGM HEALTH
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-0414
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11701 BELCHER RD S
Practice Address - Street 2:SUITE 111
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-5135
Practice Address - Country:US
Practice Address - Phone:800-632-6074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLSW00000041161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3926847Medicaid
TN4080293OtherBCBS # WPARADIGM84
TN3926847Medicare ID - Type UnspecifiedPROVIDER # W PARADIGM84