Individual provider Active NPI

Lauren H Bowen, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1265166532
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW20091 Issued in FL
Practice address
841 Prudential Dr Ste 180
Jacksonville, FL 32207-8350
Phone
(904) 202-4600
NPI assigned
Jul 13, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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 SW20091 FL Primary

Addresses

Primary practice location

841 Prudential Dr Ste 180
Jacksonville, FL 32207-8350

Mailing address

12058 San Jose Blvd Ste 703
Jacksonville, FL 32223-8668
Phone (904) 260-0454

Other practice location 1

12058 San Jose Blvd Ste 703
Jacksonville, FL 32223-8668
Phone (904) 260-0454

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW20091FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mandarin Counseling Inc Clinical CurrentSince Jul 1, 2022 Accepting new patients

Locations

12058 San Jose Blvd
Ste 703
Jacksonville, FL 32223
Phone (904) 260-0454

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1657670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1265166532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12058 SAN JOSE BLVD STE 703",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322238668",
            "telephone_number": "904-260-0454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 PRUDENTIAL DR STE 180",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078350",
            "telephone_number": "904-202-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12058 San Jose Blvd Ste 703",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322238668",
            "country_code": "US",
            "telephone_number": "904-260-0454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOWEN",
        "first_name": "LAUREN",
        "middle_name": "H",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-13",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20091",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 14, 2022; 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.