Individual provider Active NPI

Brian Martin Mandel, LCSW

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1033261656
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13299 Issued in FL
Practice address
4000 Hollywood Blvd Ste 715S
Hollywood, FL 33021-6755
Phone
(833) 769-3524
NPI assigned
Jan 16, 2007
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R048865 NY
Clinical Social Worker 1041C0700X SW13299 FL Primary

Addresses

Primary practice location

4000 Hollywood Blvd Ste 715S
Hollywood, FL 33021-6755

Mailing address

4000 Hollywood Blvd Ste 715S
Hollywood, FL 33021-6755
Phone (833) 769-3524

Other practice location 1

275 Woodfield Rd
West Hempstead, NY 11552-2530
Phone (516) 455-0685

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20080923000597 NY Practitioner - Clinical Social Worker 3476620022 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R048865NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Nov 8, 2025 Accepting new patients

Locations

4000 Hollywood Blvd
Ste 715S
Hollywood, FL 33021
Phone (754) 209-1880

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1033261656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD STE 715S",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216755",
            "telephone_number": "833-769-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 HOLLYWOOD BLVD STE 715S",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330216755",
            "telephone_number": "833-769-3524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Woodfield Rd",
            "address_purpose": "LOCATION",
            "city": "West Hempstead",
            "state": "NY",
            "postal_code": "115522530",
            "country_code": "US",
            "telephone_number": "516-455-0685",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANDEL",
        "first_name": "BRIAN",
        "middle_name": "MARTIN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R048865",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.