SRL Professional Practice & Beyond, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SRL PROFESSIONAL PRACTICE & BEYOND, LLC

Practice address

14 Mulberry St
St Augustine, FL 32084-2867

Phone

(908) 256-0282

NPI assigned

May 21, 2024

Organization subpart

No

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

Authorized official

Name

Shannon Lynch, LCSWNPI 1275164683

Title

Clinical Social Worker

Phone

(908) 256-0282

Specialties & licenses 1

Addresses

Other names 1

• SRL Mulberry Management LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Lynch, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
  • NPI 1275164683
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717113600000",
    "number": "1497594311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MULBERRY ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842867",
            "telephone_number": "908-256-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MULBERRY ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842867",
            "telephone_number": "908-256-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRL PROFESSIONAL PRACTICE & BEYOND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A",
        "authorized_official_last_name": "LYNCH",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "908-256-0282",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRL Mulberry Management LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Melissa Spies, AGNP-C
• Spinal Solutions Health and Wellness
• Spine of Life Upper Cervical Chiropractic
• Gwendolyn Marie Spong, APRN
• Dacia Lynn Sprenger, CRDH
• St Augustine Acupuncture Centre Inc
• St Augustine Adult & Pediatric Medicine PA
• St Augustine Anesthesia Partners
• St Augustine Cardiology Associates PA
• St Augustine Cardiology LLC

• Clinical Social Worker in St Augustine, FL
• Providers in St Augustine, 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 May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.