1. Home
  2. Directory
  3. Arkansas
  4. Conway
  5. Counselor
  6. NPI Profile

DERRICK WHITE LPC
NPI 1124474556
Counselor - Professional in Conway, AR

Active since May 04, 2016PECOS EnrolledAccepts Medicare Assignment
855 S GERMAN LN STE 1, CONWAY, AR 72034(501) 358-6606(501) 491-0039 Get Directions Write a Review

NPPES record last updated: May 4, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 4, 2023, Apr 17, 2020, Oct 16, 2019 and 2 more (5 updates tracked since 2017).

About Derrick White Lpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DERRICK WHITE LPC (NPI 1124474556) is an individual professional provider in Conway, Arkansas, licensed in Arkansas (P1905056) and active in the NPI registry since May 2016. He is enrolled in Medicare PECOS, maintains a secondary practice location in Conway, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1124474556
Entity TypeIndividualMale
Primary Taxonomy101YP2500X
Provider Legal NameDERRICK WHITECredential: LPC
Location Address855 S GERMAN LN STE 1Conway, AR 72034-6479
Mailing Address1820 S Salem Rd Apt 3Conway, AR 72034-8565 · (501) 908-7448 · Fax (501) 204-8612
Phone(501) 358-6606
Fax(501) 491-0039
Sole ProprietorYes
Medical School CMSOtherGraduated 2016
Enumeration DateMay 4, 2016
Last NPPES UpdateMay 4, 20235 updates tracked since enumeration
NPPES CertifiedMay 4, 2023
✔ NPI 1124474556 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in AR · P1905056
855 S GERMAN LN STE 1, Conway, AR 72034
Open in Google Maps ↗

Secondary Practice Location 1

Location 11422 Caldwell St Ste IConway, AR 72034-5319 · Phone (501) 908-7448 · Fax (501) 204-8612

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Arkansas Blue Cross and Blue Shield, Health Advantage, Octave.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derrick White Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830634385
PECOS Enrollment IDI20240709003775
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID ADAM STEINFELD CNP
Nurse Practitioner (Psychiatric/Mental Health)
855 S GERMAN LN STE 1
CONWAY, AR 72034
Faulkner County (501) 358-6606
JAMES MCCORMACK APRN PMHNP-BC
Nurse Practitioner (Psychiatric/Mental Health)
855 S GERMAN LN STE 1
CONWAY, AR 72034
Faulkner County (903) 277-5517

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Derrick White's NPI number?

The NPI number for Derrick White is 1124474556. It was assigned to this individual provider in the NPPES registry on May 4, 2016.

Where is Derrick White located?

Derrick White practices at 855 S German Ln Ste 1, Conway, AR 72034. The listed phone number is (501) 358-6606.

What is Derrick White's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Derrick White enrolled in Medicare?

Yes. Derrick White is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Derrick White accept?

Health plans from Arkansas Blue Cross and Blue Shield, Health Advantage and Octave list Derrick White as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derrick White was last updated on May 4, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.