Individual provider Active NPI

Stephanie Shoshana Eisenberger, LCSW

  • Clinical Social Worker
  • Boca Raton, FL
National Provider Identifier
1558603399
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11272 Issued in FL
Practice address
22345 Guadeloupe St
Boca Raton, FL 33433-4917
Phone
(845) 548-4535
NPI assigned
Mar 19, 2013
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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 SW11272 FL Primary

Addresses

Primary practice location

22345 Guadeloupe St
Boca Raton, FL 33433-4917

Mailing address

22345 Guadeloupe St
Boca Raton, FL 33433-4917
Phone (561) 206-4638

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
I20130515000540 FL Practitioner - Clinical Social Worker 3870730674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22345 Guadeloupe St
Boca Raton, FL 33433-4917
Phone (561) 206-4638

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shoshana Eisenberger, LCSW LLC Clinical CurrentSince Aug 26, 2017 Accepting new patients
Brain Lane Memory Center LLC Clinical Past Accepting new patients

Organizations & group practices 2

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1558603399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22345 GUADELOUPE ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334334917",
            "telephone_number": "561-206-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22345 GUADELOUPE ST",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334334917",
            "telephone_number": "845-548-4535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERGER",
        "first_name": "STEPHANIE",
        "middle_name": "SHOSHANA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.