Individual provider Active NPI

Lori T Reasonover, LCSW

  • Clinical Social Worker
  • St Augustine, FL
National Provider Identifier
1447773270
Registry record updated Jul 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14640 Issued in FL
Practice address
305 Kingsley Lake Dr Ste 702
St Augustine, FL 32092-3045
Phone
(904) 993-0019
Fax
(904) 993-0019
NPI assigned
Jul 24, 2017
Last updated
Jul 24, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2017

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 SW14640 FL Primary

Addresses

Primary practice location

305 Kingsley Lake Dr Ste 702
St Augustine, FL 32092-3045

Mailing address

4079 Glenhurst Dr N
Jacksonville, FL 32224-2297
Phone (904) 220-6883

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

State licenses

LicenseStateTypeSpecialty
SW14640FLMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500854400000",
    "number": "1447773270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4079 GLENHURST DR N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242297",
            "telephone_number": "904-220-6883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 KINGSLEY LAKE DR STE 702",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923045",
            "telephone_number": "904-993-0019",
            "fax_number": "904-993-0019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REASONOVER",
        "first_name": "LORI",
        "middle_name": "T",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2017-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; 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.