1. Home
  2. Directory
  3. Illinois
  4. South Holland
  5. Social Worker
  6. NPI Profile

MR. JOHNNY WHITE LCSW
NPI 1306149497
Social Worker - Clinical in South Holland, IL

Active since December 10, 2010PECOS Enrolled
15663 KIMBARK AVE, SOUTH HOLLAND, IL 60473(630) 747-4498 Get Directions Write a Review

NPPES record last updated: December 10, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Johnny White Lcsw NPPES

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

MR. JOHNNY WHITE LCSW (NPI 1306149497) is an individual clinical provider in South Holland, Illinois, licensed in Illinois (14900674) and active in the NPI registry since December 2010. He is enrolled in Medicare PECOS and is a graduate of Other (1993).

NPPES Registry Identity

NPI1306149497
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. JOHNNY WHITECredential: LCSW
Location Address15663 KIMBARK AVESouth Holland, IL 60473-1826
Mailing Address15663 Kimbark AveSouth Holland, IL 60473-1826 · (630) 747-4498
Phone(630) 747-4498
Sole ProprietorYes
Medical School CMSOtherGraduated 1993
Enumeration DateDecember 10, 2010
✔ NPI 1306149497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 14900674
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
15663 KIMBARK AVE, South Holland, IL 60473
Open in Google Maps ↗

Other Identifiers 1

Other14900674IL · Licensed Clinical Social Worker

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Johnny White Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9830186360
PECOS Enrollment IDI20040427001556
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $60.08 – $183.39
Typical copayment $0.00 (range $15.02 – $45.84)
Most-billed visit code NA
Established Patient
$74.80 typical visit price
range $18.97 – $148.12
Typical copayment $18.70 (range $4.74 – $37.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Documentation of Current Medications in the Medical Record
62%1,275 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
36%816 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
67%505 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
1%279 patients1/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients combinedPopulations: 55% · 520 patients
Patients screened: 58% · 520 patients
84%102 patients4/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES

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

HUE MAN SERVICE COUNSELING & CONSULTING
Social Worker (Clinical)
15663 KIMBARK AVE
SOUTH HOLLAND, IL 60473
Cook County (708) 646-0310

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 Johnny White's NPI number?

The NPI number for Johnny White is 1306149497. It was assigned to this individual provider in the NPPES registry on December 10, 2010.

Where is Johnny White located?

Johnny White practices at 15663 Kimbark Ave, South Holland, IL 60473. The listed phone number is (630) 747-4498.

What is Johnny White's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Johnny White enrolled in Medicare?

Yes. Johnny White is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Johnny White was last updated on December 10, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.