Active NPI
Aida Soraya Bernal, LCSW
- Clinical Social Worker
- Jacksonville, FL
National Provider Identifier
1427273218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 13797
- Practice address
- 5203 Bentpine Cove Rd
Jacksonville, FL 32224-0892 - Phone
- (904) 562-1391
- Fax
- (904) 562-1361
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 069324-1 | NY | |
| Clinical Social Worker | 1041C0700X | 0904006120 | VA | |
| Clinical Social Worker | 1041C0700X | SW 13797 | FL | Primary |
Addresses
Primary practice location
5203 Bentpine Cove Rd
Jacksonville, FL 32224-0892
Mailing address
5203 Bentpine Cove Rd
Jacksonville, FL 32224-0892
Phone (904) 562-1391
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW 13797 | FL | MD | Clinical Social Worker |
| 069324-1 | NY | MD | Clinical Social Worker |
| 0904006120 | VA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474588800000",
"number": "1427273218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5203 BENTPINE COVE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322240892",
"telephone_number": "904-562-1391",
"fax_number": "904-562-1361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5203 BENTPINE COVE RD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322240892",
"telephone_number": "904-562-1391",
"fax_number": "904-562-1361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERNAL",
"first_name": "AIDA",
"middle_name": "SORAYA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2016-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "069324-1",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VA",
"license": "0904006120",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 13797",
"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 Sep 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.