Active NPI
Matthew Richard Swanhart, LCSW
- Clinical Social Worker
- Green Cove Springs, FL
National Provider Identifier
1043786080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 11070
- Practice address
- 3388 Canyon Falls Dr
Green Cove Springs, FL 32043-9228 - Phone
- (904) 214-6445
- NPI assigned
- Oct 17, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 11070 | FL | Primary |
Addresses
Primary practice location
3388 Canyon Falls Dr
Green Cove Springs, FL 32043-9228
Mailing address
3388 Canyon Falls Dr
Green Cove Springs, FL 32043-9228
Phone (904) 214-6445
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11070 | Other | FL | LCSW |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11070 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539734400000",
"number": "1043786080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3388 CANYON FALLS DR",
"city": "GREEN COVE SPRINGS",
"state": "FL",
"postal_code": "320439228",
"telephone_number": "904-214-6445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3388 CANYON FALLS DR",
"city": "GREEN COVE SPRINGS",
"state": "FL",
"postal_code": "320439228",
"telephone_number": "904-214-6445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANHART",
"first_name": "MATTHEW",
"middle_name": "RICHARD",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-10-17",
"last_updated": "2018-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "11070",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "11070",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Green Cove Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.