Jacquelyn A Branche, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW13898 Issued in FL

Practice address

10000 Bay Pines Blvd
1E241C - Oef/Oif/Ond
Bay Pines, FL 33744-8200

Phone

(727) 398-6661

Fax

(727) 398-9339

NPI assigned

Aug 21, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1377043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356775787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3381 PHILLIS BLVD",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295771560",
            "telephone_number": "843-477-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 BAY PINES BLVD",
            "address_2": "1E241C - OEF/OIF/OND",
            "city": "BAY PINES",
            "state": "FL",
            "postal_code": "337448200",
            "telephone_number": "727-398-6661",
            "fax_number": "727-398-9339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3381 Phillis Blvd",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295771560",
            "country_code": "US",
            "telephone_number": "843-477-0177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANCHE",
        "first_name": "JACQUELYN",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0001124",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Diana Bowling, RD
• Chelsey Bowman
• Easton Keith Bracey, PHARMD
• Erin Brady, MSW
• Erin Michelle Brady, PHARM. D.
• Alexander Charles Branton, PHARMD
• Elizabeth G Brave, OTR/L
• Robert C. Brickner, M.D.
• Kimberlee D Bridges
• Haley Brock, RD

• Clinical Social Worker in Bay Pines, FL
• Providers in Bay Pines, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.