Active NPI
Jordan E Earle, LCSW
- Clinical Social Worker
- St. Petersburg, FL
National Provider Identifier
1316519283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW17663
- Practice address
- 2525 Pasadena Ave S
Ste M
St. Petersburg, FL 33707-4556 - Phone
- (727) 254-9183
- NPI assigned
- Jul 12, 2021
- 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 | SW17663 | FL | Primary |
Addresses
Primary practice location
2525 Pasadena Ave S
Ste M
St. Petersburg, FL 33707-4556
Mailing address
11850 Dr Martin Luther King Jr St N Apt 11310
St Petersburg, FL 33716-1630
Phone (813) 614-5649
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 |
|---|---|---|---|
| SW17663 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626048000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1316519283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11850 DR MARTIN LUTHER KING JR ST N APT 11310",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337161630",
"telephone_number": "813-614-5649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 PASADENA AVE S",
"address_2": "STE M",
"city": "ST. PETERSBURG",
"state": "FL",
"postal_code": "337074556",
"telephone_number": "727-254-9183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EARLE",
"first_name": "JORDAN",
"middle_name": "E",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-07-12",
"last_updated": "2021-07-12",
"certification_date": "2021-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW17663",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St. Petersburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.