LCN Enterprise, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

SW12949 Issued in FL

Legal business name

LCN ENTERPRISE, LLC

Doing business as

Jax Voc Rehab

Practice address

1225 W Beaver St Ste 106
Jacksonville, FL 32204

Phone

(904) 701-7998

Fax

(866) 843-7474

NPI assigned

Nov 11, 2016

Last updated

Jun 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lequita Charmine Brooks, LCSWNPI 1396042602

Title

Owner

Phone

(904) 701-7998

Specialties & licenses 6

Addresses

Other names 1

• Jax Voc Rehab Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lequita Charmine Brooks, LCSW

  • Clinical Social Worker
  • Gainesville, FL
  • NPI 1396042602
  NPD (past) Authorized official

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

{
    "created_epoch": "1478822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528588800000",
    "number": "1356883078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 N HOGAN ST",
            "address_2": "365",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322024201",
            "telephone_number": "904-701-7998",
            "fax_number": "904-278-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W BEAVER ST STE 106",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32204",
            "telephone_number": "904-701-7998",
            "fax_number": "866-843-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LCN ENTERPRISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-11",
        "last_updated": "2018-06-10",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "LEQUITA",
        "authorized_official_middle_name": "CHARMINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-701-7998",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "SW12949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jax Voc Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Jax Voc Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2018; 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.