Individual provider Active NPI

Sylvie Anne Jeanloz, LCSW

  • Clinical Social Worker
  • Sarasota, FL
National Provider Identifier
1063766590
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11662 Issued in FL
Practice address
2033 Wood St
Sarasota, FL 34237-7900
Phone
(941) 677-3366
NPI assigned
Nov 6, 2012
Last updated
Jul 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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 11662 FL Primary

Addresses

Primary practice location

2033 Wood St
Sarasota, FL 34237-7900

Mailing address

2033 Wood St
Sarasota, FL 34237-7900
Phone (941) 677-3366

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
I20140729001551 FL Practitioner - Clinical Social Worker 1456577386 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Center of Revitalizing Psychiatry, P.C.Group PAC ID 0648239988, 39 clinicians

Practice addresses (Care Compare)

12700 N Branch Rd
Sarasota, FL 34240-9003
Phone (941) 451-7568

2033 Wood St
Suite 220
Sarasota, FL 34237-7927
Phone (941) 677-3366

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11662FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Center of Revitalizing Psychiatry, P.C. CurrentSince Dec 15, 2015 Accepting new patients
Jeanloz Therapy LLC Clinical CurrentSince Sep 1, 2021 Accepting new patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Center of Revitalizing Psychiatry PC PastSince Dec 15, 2015 Accepting new patients
Family Preservation Services Past Accepting new patients

Locations

2033 Wood St
Ste 220
Sarasota, FL 34237
Phone (941) 677-3366

340 W Passaic St
Ste 1
Rochelle Park, NJ 07662
Phone (201) 488-5161

Interoperability endpoints

  • Direct secure messaging: sylviejeanloz@tdh.allscriptsdirect.net

Organizations & group practices 5

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": "1352160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1063766590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 WOOD ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342377900",
            "telephone_number": "941-677-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 WOOD ST",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342377900",
            "telephone_number": "941-677-3366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEANLOZ",
        "first_name": "SYLVIE",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-06",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "11662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.