Individual provider Active NPI

Caroline Bosarge, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1124739040
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24773 Issued in FL
Practice address
9995 Gate Pkwy N Ste 100
Jacksonville, FL 32246-0800
Phone
(833) 769-3524
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 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 MSW008504 GA
Clinical Social Worker 1041C0700X SW24773 FL Primary

Addresses

Primary practice location

9995 Gate Pkwy N Ste 100
Jacksonville, FL 32246-0800

Mailing address

9995 Gate Pkwy N Ste 100
Jacksonville, FL 32246-0800
Phone (833) 769-3524

Other practice location 1

4849 Paulsen St Ste 209
Savannah, GA 31405-4425
Phone (516) 242-6233

Other practice location 2

45 Lonnie Dr
Richmond Hill, GA 31324-6916
Phone (516) 242-6233

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
I20251222003870 FL Practitioner - Clinical Social Worker 7618462136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Personal Recovery Network LLCGroup PAC ID 5092611384, 612 clinicians

Practice addresses (Care Compare)

9995 Gate Pkwy N
Suite 100
Jacksonville, FL 32246-0800
Phone (833) 769-3524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW24773FLMDClinical Social Worker
MSW008504GAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Recovery Network LLC CurrentSince Oct 16, 2025 Accepting new patients

Locations

9995 Gate Pkwy N
Ste 100
Jacksonville, FL 32246
Phone (904) 981-1616

260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450

4849 Paulsen St
Ste 209
Savannah, GA 31405
Phone (912) 600-8800

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1124739040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9995 GATE PKWY N STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322460800",
            "telephone_number": "833-769-3524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9995 GATE PKWY N STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322460800",
            "telephone_number": "833-769-3524"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4849 Paulsen St Ste 209",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314054425",
            "country_code": "US",
            "telephone_number": "516-242-6233",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Lonnie Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond Hill",
            "state": "GA",
            "postal_code": "313246916",
            "country_code": "US",
            "telephone_number": "516-242-6233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSARGE",
        "first_name": "CAROLINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW008504",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.