Individual provider Active NPI

Vicki Suzanne Klein, LCSW

  • Clinical Social Worker
  • Sarasota, FL
National Provider Identifier
1164415592
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW1592 Issued in FL
Practice address
3205 Southgate Cir
Ste 21
Sarasota, FL 34239-5514
Phone
(941) 366-4400
Fax
(941) 366-4400
NPI assigned
Aug 31, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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 SW1592 FL Primary

Addresses

Primary practice location

3205 Southgate Cir
Ste 21
Sarasota, FL 34239-5514

Mailing address

3205 Southgate Cir
Ste 21
Sarasota, FL 34239-5514
Phone (941) 366-4400

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW1592FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jacque Ruch, LLC Clinical PastSince May 3, 2020 Accepting new patients

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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1164415592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3205 SOUTHGATE CIR",
            "address_2": "STE 21",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342395514",
            "telephone_number": "941-366-4400",
            "fax_number": "941-366-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3205 SOUTHGATE CIR",
            "address_2": "STE 21",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342395514",
            "telephone_number": "941-366-4400",
            "fax_number": "941-366-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "VICKI",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-31",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW1592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.