Organization Active NPI

Social Work Ceo, LLC

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1235825092
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SOCIAL WORK CEO, LLC
Practice address
5663 Greenland Rd
Jacksonville, FL 32258-3329
Phone
(904) 302-9355
Fax
(844) 528-1420
NPI assigned
Apr 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Authorized official

Name
Ms. Natonia S Davis, LCSW, MBANPI 1154645240
Title
Owner/Provider
Phone
(813) 760-5810

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

5663 Greenland Rd
Jacksonville, FL 32258-3329

Mailing address

6501 Arlington Expy Ste B105
Jacksonville, FL 32211-0810
Phone (904) 302-9355

Other identifiers 2

IdentifierTypeStateIssuer
003320020AMedicaidGA
121420800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230426001435 GA Part B Supplier - Clinic/Group Practice 5799140901 Receives reassigned benefits from 1 practitioner
Practice locations: Kennesaw, GA
O20230427000329 FL Part B Supplier - Clinic/Group Practice 5799140901 Receives reassigned benefits from 1 practitioner
Practice locations: Jacksonville, FL

National Provider Directory

National Provider Directory

Locations

4290 Bells Ferry Rd NW
Ste 1342280
Kennesaw, GA 30144
Phone (904) 302-9355

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1681430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745366400000",
    "number": "1235825092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 ARLINGTON EXPY STE B105",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322110810",
            "telephone_number": "904-302-9355",
            "fax_number": "844-528-1420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5663 GREENLAND RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322583329",
            "telephone_number": "904-302-9355",
            "fax_number": "844-528-1420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCIAL WORK CEO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-14",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "NATONIA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "813-760-5810",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW, MBA"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003320020A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121420800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.