Individual provider Active NPI

Jasmine Crenshaw, LCSW

  • Clinical Social Worker
  • Gainesville, FL
National Provider Identifier
1235662891
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24025 Issued in FL
Practice address
1131 NW 64TH Ter Ste a
Gainesville, FL 32605-4261
Phone
(352) 363-2025
NPI assigned
Apr 10, 2017
Last updated
Dec 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 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 SW24025 FL Primary

Addresses

Primary practice location

1131 NW 64TH Ter Ste a
Gainesville, FL 32605-4261

Mailing address

4300 SW 13TH St
Gainesville, FL 32608-4006
Phone (352) 374-5600

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
I20250117002009 FL Practitioner - Clinical Social Worker 7012446123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1131 NW 64TH Ter
Suite a
Gainesville, FL 32605-4261
Phone (239) 223-2751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW24025FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC Clinical CurrentSince Dec 21, 2024 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Dec 21, 2024 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

1131 NW 64th Ter
Ste A
Gainesville, FL 32605
Phone (352) 363-2025

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Interoperability endpoints

  • Direct secure messaging: jasmine.crenshaw.1@13142.direct.athenahealth.com

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": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1235662891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326084006",
            "telephone_number": "352-374-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 NW 64TH TER STE A",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054261",
            "telephone_number": "352-363-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRENSHAW",
        "first_name": "JASMINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.