Jerry Croan, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW5892 Issued in FL

Practice address

1361 13TH Ave S
Suite 215
Jacksonville Beach, FL 32250-3233

Phone

(904) 241-4226

Fax

(904) 270-8957

NPI assigned

Apr 23, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208908800000",
    "number": "1366617128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 13TH AVE S",
            "address_2": "SUITE # 215",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503233",
            "telephone_number": "904-241-4226",
            "fax_number": "904-270-8957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1361 13TH AVE S",
            "address_2": "SUITE 215",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322503233",
            "telephone_number": "904-241-4226",
            "fax_number": "904-270-8957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROAN",
        "first_name": "JERRY",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Crew
• Ronda Crews, ARNP
• Michelle Connolly Cribbs, M.S., CCC-SLP
• Tara Cripe, M.S., CCC-SLP
• Nicholas Cristello, ARNP
• John Richard Crossfield, LHMC
• Crossroads Therapy, LLC
• Tawnie Crowe, PT, DPT
• Jennifer Cruz Hernandez
• Wilfreda Jenine Cruz, LCSW, LCSW-C

• Clinical Social Worker in Jacksonville Beach, FL
• Providers in Jacksonville Beach, 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 Apr 23, 2008; 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.