Individual provider Active NPI

Janean Furdock, LCSW

  • Clinical Social Worker
  • Eustis, FL
National Provider Identifier
1548315138
Registry record updated Dec 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7776 Issued in FL
Practice address
35114 Stagecoach TRL
Eustis, FL 32736-8004
Phone
(321) 377-2243
Fax
(352) 589-6738
NPI assigned
Jan 24, 2007
Last updated
Dec 1, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2016

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 SW7776 FL Primary

Addresses

Primary practice location

35114 Stagecoach TRL
Eustis, FL 32736-8004

Mailing address

35114 Stagecoach TRL
Eustis, FL 32736-8004
Phone (321) 377-2243

Other identifiers 1

IdentifierTypeStateIssuer
015483300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150813009831 FL Practitioner - Clinical Social Worker 3971818428 Reassigns benefits to 1 organization
Practice locations: Eustis, FL; Longwood, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

35114 Stagecoach TRL
Eustis, FL 32736-8004
Phone (321) 377-2243

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Resource Services, Inc. CurrentSince Aug 11, 2016 Accepting new patients
Janean Furdock, LCSW Clinical PastSince May 30, 2015 Accepting new patients

Locations

13350 W Colonial Dr
Ste 340
Winter Garden, FL 34787
Phone (407) 654-4433

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1548315138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35114 STAGECOACH TRL",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327368004",
            "telephone_number": "321-377-2243",
            "fax_number": "352-589-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35114 STAGECOACH TRL",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327368004",
            "telephone_number": "321-377-2243",
            "fax_number": "352-589-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FURDOCK",
        "first_name": "JANEAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015483300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eustis, FL

Sources for this page

Verify at the official NPI Registry.