Individual provider Active NPI

Sade Kirkpatrick, MSW, RCSWI

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1518627934
Registry record updated Oct 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW17088 Issued in FL
Practice address
6859 Lenox Ave Ste 13
Jacksonville, FL 32205-6149
Phone
(904) 431-7188
NPI assigned
Dec 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2023

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 ISW17088 FL Primary

Addresses

Primary practice location

6859 Lenox Ave Ste 13
Jacksonville, FL 32205-6149

Mailing address

6821 Misty View Dr
Jacksonville, FL 32210-0401
Phone (904) 729-1422

Other practice location 1

6821 Misty View Dr
Jacksonville, FL 32210-0401
Phone (904) 729-1422

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
ISW17088FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1640563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1518627934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6821 MISTY VIEW DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322100401",
            "telephone_number": "904-729-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6859 LENOX AVE STE 13",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322056149",
            "telephone_number": "904-431-7188"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6821 Misty View Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322100401",
            "country_code": "US",
            "telephone_number": "904-729-1422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIRKPATRICK",
        "first_name": "SADE",
        "credential": "MSW, RCSWI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-27",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW17088",
            "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 Oct 13, 2023; 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.