NPIMap

Organization Active NPI

Life Solutions Services

  • Clinical Social Worker
  • Brandon, FL
National Provider Identifier
1508345521
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9563 Issued in FL
Legal business name
LIFE SOLUTIONS SERVICES
Practice address
710 Oakfield Dr Ste 206
Brandon, FL 33511-4954
Phone
(754) 800-3261
NPI assigned
Aug 9, 2018
Last updated
Sep 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Authorized official

Name
Jennifer Allen
Title
Credentialing Specialist
Phone
(813) 361-7927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW9563 FL Primary

Addresses

Primary practice location

710 Oakfield Dr Ste 206
Brandon, FL 33511-4954

Mailing address

122 Hickory Creek Blvd
Brandon, FL 33511-8061
Phone (754) 800-3261

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181231000973 FL Part B Supplier - Clinic/Group Practice 1052656618 Receives reassigned benefits from 11 practitioners
Practice locations: Brandon, FL

National Provider Directory

National Provider Directory

Locations

108 Mason St
Brandon, FL 33511
Phone (754) 800-3261

710 Oakfield Dr
Ste 206
Brandon, FL 33511
Phone (754) 800-3261

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1508345521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 HICKORY CREEK BLVD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118061",
            "telephone_number": "754-800-3261",
            "fax_number": "813-689-3815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 OAKFIELD DR STE 206",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114954",
            "telephone_number": "754-800-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SOLUTIONS SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "813-361-7927"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.