Active NPI
Lynette Yvonne Bledsoe, LCSW
- Clinical Social Worker
- Cantonment, FL
National Provider Identifier
1275797441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW10108
- Practice address
- 2161 S Highway 97
Cantonment, FL 32533-6711 - Phone
- (850) 712-6901
- NPI assigned
- Jul 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW10108 | FL | Primary |
Addresses
Primary practice location
2161 S Highway 97
Cantonment, FL 32533-6711
Mailing address
2161 S Highway 97
Cantonment, FL 32533-6711
Phone (850) 712-6901
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW10108 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1275797441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2161 S HIGHWAY 97",
"city": "CANTONMENT",
"state": "FL",
"postal_code": "325336711",
"telephone_number": "850-712-6901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2161 S HIGHWAY 97",
"city": "CANTONMENT",
"state": "FL",
"postal_code": "325336711",
"telephone_number": "850-712-6901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLEDSOE",
"first_name": "LYNETTE",
"middle_name": "YVONNE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-16",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW10108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cantonment, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.