Individual provider Active NPI

Brandy Suzanne Forman, LCSW

  • Clinical Social Worker
  • Ocala, FL
National Provider Identifier
1558039941
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11920 Issued in FL
Practice address
1012 E Silver Springs Blvd Ste B7&8
Ocala, FL 34470-6781
Phone
(352) 405-0789
NPI assigned
Sep 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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 SW11920 FL Primary

Addresses

Primary practice location

1012 E Silver Springs Blvd Ste B7&8
Ocala, FL 34470-6781

Mailing address

1309 SE 43Rd Ave
Ocala, FL 34471-4944
Phone (352) 843-6222

Other practice location 1

98 NE 9th St
Ocala, FL 34470-6694
Phone (352) 405-0789

Other identifiers 1

IdentifierTypeStateIssuer
SW11920OtherFLLICENSED CLINICAL SOCIAL WORKER - LCSW

Other names 1

  • Brandy Suzanne Foreman-Kraft Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address brandy@weargloves.org Direct

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
I20221216001146 FL Practitioner - Clinical Social Worker 5395111645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11920FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Apr 10, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1558039941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1309 SE 43RD AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714944",
            "telephone_number": "352-843-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 E SILVER SPRINGS BLVD STE B7&8",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344706781",
            "telephone_number": "352-405-0789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "98 NE 9th St",
            "address_purpose": "LOCATION",
            "city": "Ocala",
            "state": "FL",
            "postal_code": "344706694",
            "country_code": "US",
            "telephone_number": "352-405-0789",
            "fax_number": "844-444-1046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "BRANDY",
        "middle_name": "SUZANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER - LCSW",
            "identifier": "SW11920",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "brandy@weargloves.org",
            "affiliation": "N",
            "endpointDescription": "professional email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1012 E Silver Springs Blvd Ste B7&8",
            "city": "Ocala",
            "state": "FL",
            "country_code": "US",
            "postal_code": "344706781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "FOREMAN-KRAFT",
            "middle_name": "SUZANNE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ocala, FL

Sources for this page

Verify at the official NPI Registry.