Ian Taylor White, LISCSW
Social Worker, Clinical in Hermantown, MN. Individual provider (NPI-1).
NPI number1184366189
StatusActive
Last updated in NPPESApr 30, 2025
Details
- NPI
- 1184366189
- Entity type
- Individual (NPI-1)
- Name
- Ian Taylor White
- Credential
- LISCSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 11, 2022
- Certification date
- Apr 30, 2025
- Last updated
- Apr 30, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 30764 | MN | Yes |
| 103K00000X | Behavior Analyst | – | – |
Practice location
4855 W Arrowhead RdHermantown, MN 55811-3936
Phone 218-786-3540
Mailing address
400 E 3rd StDuluth, MN 55805-1951
Phone 218-786-8364
Other practice locations
5155 Miller Trunk Hwy
Hermantown, MN 55811-1203
Hermantown, MN 55811-1203
Phone 952-767-4200
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 14 Clinical Social Worker providers in Hermantown · All 401 providers in Hermantown
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