Individual provider Active NPI

Elisabeth Ochs Shorstein, MSW, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1124102686
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7365 Issued in FL
Practice address
2950 Halcyon LN Ste 703
Jacksonville, FL 32223-6692
Phone
(904) 868-4400
Fax
(904) 739-2069
NPI assigned
Oct 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 SW7365 FL Primary

Addresses

Primary practice location

2950 Halcyon LN Ste 703
Jacksonville, FL 32223-6692

Mailing address

2950 Halcyon LN Ste 703
Jacksonville, FL 32223-6692
Phone (904) 868-4400

Other identifiers 1

IdentifierTypeStateIssuer
765077900MedicaidFL

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
I20041215000513 FL Practitioner - Clinical Social Worker 3577520162 Practice locations: Jacksonville, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6034 Chester Ave
Suite 104
Jacksonville, FL 32217-2237
Phone (904) 868-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW7365FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1124102686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 HALCYON LN STE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236692",
            "telephone_number": "904-868-4400",
            "fax_number": "904-739-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 HALCYON LN STE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322236692",
            "telephone_number": "904-868-4400",
            "fax_number": "904-739-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORSTEIN",
        "first_name": "ELISABETH",
        "middle_name": "OCHS",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "765077900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.