Active NPI
Elaine Wallen
- School Social Worker
- Pembroke Pines, FL
National Provider Identifier
1114464864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 838357
- Practice address
- 1000 N Hiatus Rd
Suite 140/161
Pembroke Pines, FL 33026-3097 - Phone
- (954) 333-8787
- Fax
- (954) 333-8621
- NPI assigned
- Jan 19, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 838357 | FL | Primary |
Addresses
Primary practice location
1000 N Hiatus Rd
Suite 140/161
Pembroke Pines, FL 33026-3097
Mailing address
1000 N Hiatus Rd
Suite 140/161
Pembroke Pines, FL 33026-3097
Phone (954) 333-8787
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 |
|---|---|---|---|
| 838357 | FL | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484784000000",
"number": "1114464864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 N HIATUS RD",
"address_2": "SUITE 140/161",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330263097",
"telephone_number": "954-333-8787",
"fax_number": "954-333-8621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 N HIATUS RD",
"address_2": "SUITE 140/161",
"city": "PEMBROKE PINES",
"state": "FL",
"postal_code": "330263097",
"telephone_number": "954-333-8787",
"fax_number": "954-333-8621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLEN",
"first_name": "ELAINE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-01-19",
"last_updated": "2017-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "FL",
"license": "838357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pembroke Pines, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.