Susan Lee

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW2323 Issued in FL

Practice address

12086 Ft.Caroline Rd Suite 401
Jacksonville, FL 32225-1536

Phone

(904) 565-1271

Fax

(904) 645-7325

NPI assigned

Feb 18, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ellis Pediatrics, PLLC

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1134844426
  NPD
• Jewish Family and Community Services

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1861264418
  NPD
• Kids and Families Medical Clinic LLC

  • Adolescent Medicine (Family Medicine) Physician
  • Jacksonville, FL
  • NPI 1891359998
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1003230657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12086 FORT CAROLINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252687",
            "telephone_number": "904-565-1271",
            "fax_number": "904-645-7325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12086 FT.CAROLINE RD SUITE 401",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322251536",
            "telephone_number": "904-565-1271",
            "fax_number": "904-645-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW2323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SW2323",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry Denise Lee, CRNA
• Steven Y Lee, M.D.
• Su Ji Lee, DMD
• Sujin Lee, M.D
• Sungyoung Lee, MD
• Tiffany Lee, RD
• William Lee, MD
• William Dewey Lee III, PA
• Won Lee
• Yeonsoo Sara Lee, MD

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.