Individual provider Active NPI

Jennifer Patricia Taylor, LCSW

  • Social Worker
  • Sarasota, FL
National Provider Identifier
1568554608
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
5763 Rosin Way
Sarasota, FL 34233-4401
Phone
(850) 529-8057
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 8963 FL
Social Worker 104100000X Primary

Addresses

Primary practice location

5763 Rosin Way
Sarasota, FL 34233-4401

Mailing address

6251 Yellow Wood PL
Sarasota, FL 34241-8316
Phone (850) 529-8057

Other practice location 1

5750 Park Heights Ave
Baltimore, MD 21215-3930
Phone (410) 466-9200

Other identifiers 1

IdentifierTypeStateIssuer
767860600MedicaidFL

Other names 1

  • Jennifer Patricia Boudreaux Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8963FLMDClinical Social Worker
26629MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Associates, P.a. Single Specialty PastSince Aug 13, 2002 Accepting new patients
Jennifer Taylor Play Therapy Services LLC PastSince May 18, 2025 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1568554608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6251 YELLOW WOOD PL",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342418316",
            "telephone_number": "850-529-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5763 ROSIN WAY",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342334401",
            "telephone_number": "850-529-8057"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5750 Park Heights Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212153930",
            "country_code": "US",
            "telephone_number": "410-466-9200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "middle_name": "PATRICIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "8963",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767860600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BOUDREAUX",
            "middle_name": "PATRICIA",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.