Individual provider Active NPI

Jo Ellen Dyer, LCSW

  • Clinical Social Worker
  • Stuart, FL
National Provider Identifier
1386972792
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9465 Issued in FL
Practice address
300 Colorado Ave
Suite 202
Stuart, FL 34994-2103
Phone
(772) 223-1220
Fax
(772) 223-1220
NPI assigned
Nov 23, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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 SW9465 FL Primary

Addresses

Primary practice location

300 Colorado Ave
Suite 202
Stuart, FL 34994-2103

Mailing address

300 Colorado Ave
Suite 202
Stuart, FL 34994-2103
Phone (772) 223-1220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325000947 FL Practitioner - Clinical Social Worker 5597891812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Barry University School of Podiatric Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 Colorado Ave
Stuart, FL 34994-2103
Phone (772) 223-1220

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW9465FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Here for You, LLC Clinical CurrentSince Oct 1, 2009 Accepting new patients

Locations

300 S Colorado Ave
Ste 202
Stuart, FL 34994
Phone (772) 215-5568

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258934400000",
    "number": "1386972792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 COLORADO AVE",
            "address_2": "SUITE 202",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942103",
            "telephone_number": "772-223-1220",
            "fax_number": "772-223-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLORADO AVE",
            "address_2": "SUITE 202",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349942103",
            "telephone_number": "772-223-1220",
            "fax_number": "772-223-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "JO ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-23",
        "last_updated": "2009-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.