Active NPI
Jake Swanson, LCSW
- Clinical Social Worker
- Melbourne, FL
National Provider Identifier
1609480383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW20648
- Practice address
- 3932 W Eau Gallie Blvd Ste 101
Melbourne, FL 32934-3283 - Phone
- (321) 207-8495
- Fax
- (709) 400-7957
- NPI assigned
- Sep 1, 2020
- Last updated
- Apr 24, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW20648 | FL | Primary |
Addresses
Primary practice location
3932 W Eau Gallie Blvd Ste 101
Melbourne, FL 32934-3283
Mailing address
3932 W Eau Gallie Blvd Ste 101
Melbourne, FL 32934-3283
Phone (321) 207-8495
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW20648 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Balanced Wellbeing LLC | Clinical | Current | Accepting new patients |
Locations
3200 SW 34th Ave
Ste 701
Ocala, FL 34474
Phone (354) 445-1200
Networks
- Freedom Health HMO Network
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": "1598918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745452800000",
"number": "1609480383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3932 W EAU GALLIE BLVD STE 101",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329343283",
"telephone_number": "321-207-8495",
"fax_number": "709-400-7957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3932 W EAU GALLIE BLVD STE 101",
"city": "MELBOURNE",
"state": "FL",
"postal_code": "329343283",
"telephone_number": "321-207-8495",
"fax_number": "709-400-7957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWANSON",
"first_name": "JAKE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-01",
"last_updated": "2025-04-24",
"certification_date": "2025-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW20648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Melbourne, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.