Individual provider Active NPI

James S Segal,, MSW, LCSW

  • Clinical Social Worker
  • Gainesville, FL
National Provider Identifier
1205074671
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
702 Issued in FL
Practice address
1505 NW 16TH Ave
Gainesville, FL 32605-4036
Phone
(352) 475-1956
NPI assigned
Jan 23, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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 702 FL Primary
Marriage & Family Therapist 106H00000X 532 FL

Addresses

Primary practice location

1505 NW 16TH Ave
Gainesville, FL 32605-4036

Mailing address

6212 Latchstring Rd
Melrose, FL 32666-6138
Phone (352) 475-3100

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
532FLMDMarriage & Family Therapist
702FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232668800000",
    "number": "1205074671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6212 LATCHSTRING RD",
            "city": "MELROSE",
            "state": "FL",
            "postal_code": "326666138",
            "telephone_number": "352-475-3100",
            "fax_number": "305-359-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 NW 16TH AVE",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054036",
            "telephone_number": "352-475-1956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGAL,",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "702",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "532",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.