Individual provider Active NPI

Kahlia Marissa Bersson, LCSW

  • Clinical Social Worker
  • Coral Springs, FL
National Provider Identifier
1326888769
Registry record updated May 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11709 Issued in FL
Practice address
3851 NW 108TH Dr
Coral Springs, FL 33065-2714
Phone
(305) 987-0920
NPI assigned
May 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 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 SW11709 FL Primary

Addresses

Primary practice location

3851 NW 108TH Dr
Coral Springs, FL 33065-2714

Mailing address

3851 NW 108TH Dr
Coral Springs, FL 33065-2714
Phone (305) 987-0920

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

LicenseStateTypeSpecialty
SW11709FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1326888769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 NW 108TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652714",
            "telephone_number": "305-987-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 NW 108TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330652714",
            "telephone_number": "305-987-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERSSON",
        "first_name": "KAHLIA",
        "middle_name": "MARISSA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; 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.