Individual provider Active NPI

Jaclyn Braun, LCSW

  • Social Worker
  • Orlando, FL
National Provider Identifier
1568857159
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
612 E Colonial Dr Ste 390
Orlando, FL 32803-4650
Phone
(407) 801-1990
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

612 E Colonial Dr Ste 390
Orlando, FL 32803-4650

Mailing address

612 E Colonial Dr Ste 390
Orlando, FL 32803-4650
Phone (407) 801-1990

Other practice location 1

1009 Maitland Center Commons Blvd
#212
Maitland, FL 32751-7270
Phone (407) 801-1990

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
I20190409000516 FL Practitioner - Clinical Social Worker 3274874862 Practice locations: Orlando, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

612 E Colonial Dr
Suite 390
Orlando, FL 32803-4650
Phone (407) 801-1990

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Bonds Counseling, LLC Past Accepting new patients

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, 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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1568857159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 E COLONIAL DR STE 390",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034650",
            "telephone_number": "407-801-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 E COLONIAL DR STE 390",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034650",
            "telephone_number": "407-801-1990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1009 Maitland Center Commons Blvd",
            "address_2": "#212",
            "address_purpose": "LOCATION",
            "city": "Maitland",
            "state": "FL",
            "postal_code": "327517270",
            "country_code": "US",
            "telephone_number": "407-801-1990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAUN",
        "first_name": "JACLYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.