Dr Charla Jeanine White, - Medicare Psychologist in Woodbridge, VA

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Dr Charla Jeanine White, is a medicare enrolled "Psychologist - Clinical" provider in Woodbridge, Virginia. Her current practice location is 12309 Wadsworth Way, Woodbridge, Virginia. You can reach out to her office (for appointments etc.) via phone at (571) 228-9576.

Dr Charla Jeanine White is licensed to practice in Virginia (license number 0810003345) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1063489862.

Contact Information

Dr Charla Jeanine White,
12309 Wadsworth Way,
Woodbridge, VA 22192-6245
(571) 228-9576
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Charla Jeanine White
GenderFemale
SpecialityPsychologist - Clinical
Location12309 Wadsworth Way, Woodbridge, Virginia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1063489862
  • Provider Enumeration Date: 03/01/2006
  • Last Update Date: 09/14/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 6002873494
  • Enrollment ID: I20041217000019

Medical Identifiers

Medical identifiers for Dr Charla Jeanine White such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1063489862NPI-NPPES
0515622MedicaidVA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103TC0700XPsychologist - Clinical 0810003345 (Virginia)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Charla Jeanine White allows following entities to bill medicare on her behalf.
Entity NameWalston Health Services LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023460912
PECOS PAC ID: 0244592798
Enrollment ID: O20180320002959
Entity NameSupportive Care of Maryland LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1447802616
PECOS PAC ID: 9234460999
Enrollment ID: O20191010000282

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Charla Jeanine White is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Charla Jeanine White,
12309 Wadsworth Way,
Woodbridge, VA 22192-6245

Ph: (703) 680-5146		Dr Charla Jeanine White,
12309 Wadsworth Way,
Woodbridge, VA 22192-6245

Ph: (571) 228-9576

Reviews and Comments


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