Individual provider Active NPI

Jean D Pierre, LCSW

  • Clinical Social Worker
  • Cutler Bay, FL
National Provider Identifier
1184992638
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10853 Issued in FL
Practice address
10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone
(305) 252-4840
NPI assigned
Dec 12, 2011
Last updated
Jan 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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 SW10853 FL Primary

Addresses

Primary practice location

10300 SW 216TH St
Cutler Bay, FL 33190-1003

Mailing address

10300 SW 216TH St
Cutler Bay, FL 33190-1003
Phone (305) 252-4840

Other identifiers 4

IdentifierTypeStateIssuer
ISW4908OtherFLFLORIDA LICENSURE
004325400MedicaidFL
005526400MedicaidFL
SW10853OtherFLLICENSE

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
I20121127000057 FL Practitioner - Clinical Social Worker 3577714492 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW10853FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of South Florida Inc CurrentSince Aug 25, 2017 Accepting new patients
Community Health of South Florida, Inc CurrentSince Aug 25, 2017 Accepting new patients

Locations

10300 SW 216th St
Cutler Bay, FL 33190

Organizations & group practices 2

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": "1323648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1184992638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-252-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 SW 216TH ST",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331901003",
            "telephone_number": "305-252-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE",
        "first_name": "JEAN",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-12",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSURE",
            "identifier": "ISW4908",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004325400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005526400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SW10853",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cutler Bay, FL

Sources for this page

Verify at the official NPI Registry.