Individual provider Active NPI

Elizabeth Simon Klasko, L.C.S.W.

  • Clinical Social Worker
  • Boynton Beach, FL
National Provider Identifier
1023247301
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9258 Issued in FL
Practice address
6196 Key Largo LN
Boynton Beach, FL 33472-2370
Phone
(610) 390-4900
NPI assigned
Jul 8, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW9258 FL Primary

Addresses

Primary practice location

6196 Key Largo LN
Boynton Beach, FL 33472-2370

Mailing address

6196 Key Largo LN
Boynton Beach, FL 33472-2370
Phone (610) 390-4900

Other practice location 1

1200 NW 17th Ave Ste 12
Delray Beach, FL 33445-2512
Phone (561) 732-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091112000637 FL Practitioner - Clinical Social Worker 6204974157 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Different Like Me IncGroup PAC ID 0840385753, 10 clinicians

Practice addresses (Care Compare)

1601 Clint Moore Rd
Suite 120
Boca Raton, FL 33487-5712
Phone (561) 270-2280

6196 Key Largo LN
Boynton Beach, FL 33472-2370
Phone (610) 390-4900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW9258FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Different Like Me Inc Clinical CurrentSince Nov 17, 2016 Accepting new patients
Elizabeth Klasko LCSW LLC Clinical CurrentSince Sep 1, 2021 Accepting new patients
The Guidance Program Past Accepting new patients

Locations

1601 Clint Moore Rd
Ste 120
Boca Raton, FL 33487
Phone (561) 270-2280

1200 NW 17th Ave
Ste 12
Delray Beach, FL 33445
Phone (561) 270-2280

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581984000000",
    "number": "1023247301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6196 KEY LARGO LN",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334722370",
            "telephone_number": "610-390-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6196 KEY LARGO LN",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334722370",
            "telephone_number": "610-390-4900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 NW 17th Ave Ste 12",
            "address_purpose": "LOCATION",
            "city": "Delray Beach",
            "state": "FL",
            "postal_code": "334452512",
            "country_code": "US",
            "telephone_number": "561-732-7000",
            "fax_number": "561-536-5753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLASKO",
        "first_name": "ELIZABETH",
        "middle_name": "SIMON",
        "name_prefix": "Mrs.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-08",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.