Individual provider Active NPI

Jae J. Pate, LCSW

  • Clinical Social Worker
  • Tyndall Afb, FL
National Provider Identifier
1356315600
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0002390 Issued in FL
Practice address
340 Magnolia Circle
325 Mdos/Sgohsf
Tyndall Afb, FL 32404
Phone
(850) 283-7511
Fax
(850) 283-7721
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 0002390 FL Primary

Addresses

Primary practice location

340 Magnolia Circle
325 Mdos/Sgohsf
Tyndall Afb, FL 32404

Mailing address

325 Mdos/Sgohsf
Tyndall Afb, FL 32404
Phone (850) 283-7511

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
0002390FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1356315600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MDOS/SGOHSF",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "32404",
            "telephone_number": "850-283-7511",
            "fax_number": "850-283-7721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAGNOLIA CIRCLE",
            "address_2": "325 MDOS/SGOHSF",
            "city": "TYNDALL AFB",
            "state": "FL",
            "postal_code": "32404",
            "telephone_number": "850-283-7511",
            "fax_number": "850-283-7721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATE",
        "first_name": "JAE",
        "middle_name": "J.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "0002390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyndall Afb, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.