Individual ProviderJordan Renee WhiteCounselorBehavioral Health & Social Service ProvidersPractice Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067(702) 437-4673PECOS EnrollmentBased on the most recent information from CMS, provider Jordan Renee White does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1154926038Provider TypeIndividualFull NameWhite, Jordan ReneeCredentialQMHAGenderFemaleSole ProprietorNoEnumeration Date12/1/2020Last Updated12/1/2020Contact InformationPractice LocationPractice Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067Phone(702) 437-4673Fax(702) 438-4673Mailing LocationMailing Address6600 W Charleston Blvd Ste 140, Las Vegas, NV 89146-1067Phone(702) 437-4673Fax(702) 438-4673Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer