Individual provider Active NPI

Lillie Carter-Ford

  • Social Worker
  • Jacksonville, FL
National Provider Identifier
1407994759
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
3333 W 20TH St
Jacksonville, FL 32254-1703
Phone
(904) 945-3511
Fax
(904) 493-4468
NPI assigned
Feb 1, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

3333 W 20TH St
Jacksonville, FL 32254-1703

Mailing address

988 Ashton Cove Ter
Jacksonville, FL 32218-6126
Phone (904) 612-4791

Other practice location 1

11820 Beach Blvd
Jacksonville, FL 32246-6670
Phone (904) 642-9100 ext. 237

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Resource Center Inc Past Accepting new patients

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": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1407994759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 ASHTON COVE TER",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186126",
            "telephone_number": "904-612-4791",
            "fax_number": "904-641-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W 20TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541703",
            "telephone_number": "904-945-3511",
            "fax_number": "904-493-4468"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11820 Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322466670",
            "country_code": "US",
            "telephone_number": "904-642-9100 x237",
            "fax_number": "904-641-6529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTER-FORD",
        "first_name": "LILLIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.