Daniel Louis Bologna, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW000254 Issued in FL

Practice address

840 Brevard Ave
Rockledge, FL 32955-2149

Phone

(321) 632-5792

NPI assigned

Mar 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Family Counseling Center of Brevard Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cocoa, FL
  • NPI 1003876400

  Clinical

  NPD (past)
• Family Counseling Center of Brevard, Inc.

  • Community/Behavioral Health Agency
  • Rockledge, FL
  • NPI 1912053919
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244505600000",
    "number": "1508990896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 BREVARD AVE",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552149",
            "telephone_number": "321-632-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 BREVARD AVE",
            "city": "ROCKLEDGE",
            "state": "FL",
            "postal_code": "329552149",
            "telephone_number": "321-632-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLOGNA",
        "first_name": "DANIEL",
        "middle_name": "LOUIS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2009-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW000254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "62-40039",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "275862",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060332500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jesse Blain I
• Tully T. Blalock Jr., MD
• Jayna-Lonyea Blanks
• Blessings Adult Family Care Home
• Bobby Abraham MD PA
• Courtney Bordac
• Amber Borns
• Timothy J Bortz, DC
• Matthew Norman Boucher, DC
• Shondell M Bouie, MD

• All providers in Rockledge, FL
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; 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.