Individual provider Active NPI

Jennifer Lacasse

  • Clinical Social Worker
  • Live Oak, FL
National Provider Identifier
1194178814
Registry record updated Oct 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW16163 Issued in FL
Practice address
1373 Ohio Ave N
Live Oak, FL 32064-0440
Phone
(352) 374-5600
NPI assigned
Jul 18, 2016
Last updated
Oct 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X SW16163 FL
Clinical Social Worker 1041C0700X SW16163 FL Primary

Addresses

Primary practice location

1373 Ohio Ave N
Live Oak, FL 32064-0440

Mailing address

1373 Ohio Ave N
Live Oak, FL 32064-4006

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
I20190618000550 FL Practitioner - Clinical Social Worker 2769715127 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1373 Ohio Ave N
Live Oak, FL 32064-4815
Phone (386) 590-7096

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW16163FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Health Center, Inc. CurrentSince Jan 10, 2024 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Mar 10, 2023 Accepting new patients
Meridian Behavioral Healthcare, Inc. CurrentSince Jul 26, 2019 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince May 1, 2025 Accepting new patients

Locations

4300 SW 13th St
Gainesville, FL 32608

439 SW Michigan St
Lake City, FL 32025
Phone (386) 487-0800

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

1373 Ohio Ave N
Live Oak, FL 32064
Phone (386) 590-7096

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 5

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": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696550400000",
    "number": "1194178814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 OHIO AVE N",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320644006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1373 OHIO AVE N",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320640440",
            "telephone_number": "352-374-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACASSE",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2023-10-06",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW16163",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, FL

Sources for this page

Verify at the official NPI Registry.