Dominique White | White Plains, NY • PECOS Search

Dominique White

Social Worker

Behavioral Health & Social Service Providers

21 Bloomingdale Rd, White Plains, NY 10605-1504

PECOS Enrollment

Based on the most recent information from CMS, provider Dominique White does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1205205986
Provider Type
Individual
Full Name
White, Dominique
Credential
LMSW

Gender
Female
Sole Proprietor
No
Enumeration Date
9/23/2015
Last Updated
9/23/2015

Contact Information

Practice Location

21 Bloomingdale Rd, White Plains, NY 10605-1504

Unlisted Fax

Mailing Location

21 Bloomingdale Rd, White Plains, NY 10605-1504

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 089140 New York