MICHELE JACQUELINE WHITE (MA) – Marriage & Family Therapist, NPI 1275886632

MICHELE JACQUELINE WHITE (MA) is a healthcare provider. based in Mpls, Minnesota. specializing in MARRIAGE AND FAMILY THERAPIST. They hold the professional credentials MA. They hold a License No. 2411 (MN). The NPI Number for MICHELE JACQUELINE WHITE (MA) is 1275886632

Main info

Female
16 Years Of Experience
Accepts Medicare Assignment
Name
MICHELE JACQUELINE WHITE (MA)
NPI
1275886632
Phone
(612) 916-8819
Address
2601 JOHNSON ST. N.E.
Enumeration Date
23 October 2012
Last Update Date
26 October 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9528981133
Graduation Year
2010 (16 years ago)
PAC ID
0042663734
Group Practice PAC ID
5890779847
Professional Enrollment ID
I20240130000690
Address ID
MN550448348LA7580XWXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:13State licenses:1Digital endpointsOther names

981 MARRIAGE AND FAMILY THERAPIST in MN

Provider Addresses for MICHELE JACQUELINE WHITE (MA)

  • 2601 JOHNSON ST. N.E.

    MPLS, MN 55418

    Phone: (612) 916-8819

    Fax: (651) 407-3751

    Type: Mailing

  • 7580 160TH ST W

    LAKEVILLE, MN 550448348

    Phone: (952) 898-1133

    Fax: (952) 435-6797

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240130000690IMarriage And Family TherapistMNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55418)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5890779847View full group profile
NameSpecialtyState
Clinical Social WorkerMN
Mental Health CounselorMN
Marriage And Family TherapistMN
Marriage And Family TherapistMN
-MN
Mental Health CounselorMN
Marriage And Family TherapistMN
Clinical Social WorkerMN
Marriage And Family TherapistMN
Clinical Social WorkerMN

Reviews

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Frequently asked questions

How is MICHELE JACQUELINE WHITE (MA) identified in CMS data?
CMS-hosted NPPES data lists MICHELE JACQUELINE WHITE (MA) with NPI 1275886632.
Is MICHELE JACQUELINE WHITE (MA) listed as active for patients and plans?
The listing shows MICHELE JACQUELINE WHITE (MA) as active in the NPI system.
What taxonomy line describes MICHELE JACQUELINE WHITE (MA)?
For research purposes, treat MICHELE JACQUELINE WHITE (MA) as Marriage & Family Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where is MICHELE JACQUELINE WHITE (MA) based?
MICHELE JACQUELINE WHITE (MA) is tied to Mpls, Minnesota in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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