Organization Active NPI

Kristin Solberg, LCSW, LLC.

  • Clinical Social Worker
  • Winter Park, FL
National Provider Identifier
1356719686
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9298 Issued in FL
Legal business name
KRISTIN SOLBERG, LCSW, LLC.
Practice address
1345 Clay St
Winter Park, FL 32789-5404
Phone
(407) 340-1708
Fax
(407) 641-9245
NPI assigned
Sep 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristin Elizabeth Solberg, LCSW, CEDS
Title
Owner/Therapist
Phone
(407) 340-1708

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW9298 FL Primary

Addresses

Primary practice location

1345 Clay St
Winter Park, FL 32789-5404

Mailing address

1345 Clay St
Winter Park, FL 32789-5404
Phone (407) 340-1708

Other identifiers 1

IdentifierTypeStateIssuer
005455300MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1356719686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 CLAY ST",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895404",
            "telephone_number": "407-340-1708",
            "fax_number": "407-641-9245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 CLAY ST",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327895404",
            "telephone_number": "407-340-1708",
            "fax_number": "407-641-9245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN SOLBERG, LCSW, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "SOLBERG",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "407-340-1708",
        "authorized_official_credential": "LCSW, CEDS"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005455300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.