Individual provider Active NPI

Fred Sacklow, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1619968716
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14596 Issued in FL
Practice address
6950 Philips Hwy Ste 11
Jacksonville, FL 32216
Phone
(904) 239-3677
Fax
(904) 866-4029
NPI assigned
Oct 30, 2005
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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 SW14596 FL Primary

Addresses

Primary practice location

6950 Philips Hwy Ste 11
Jacksonville, FL 32216

Mailing address

2055 Reyko Rd Ste 100
Jacksonville, FL 32207-2828
Phone (904) 648-8200

Other practice location 1

2055 Reyko Rd Ste 100
Jacksonville, FL 32207-2828
Phone (904) 648-8200

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
I20180530003159 FL Practitioner - Clinical Social Worker 4981861002 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gauler and Associates, LLCGroup PAC ID 6901046945, 5 clinicians

Practice addresses (Care Compare)

13111 Atlantic Blvd
2 Flces Intracoastal West
Jacksonville, FL 32225-3125
Phone (904) 239-3677

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14596FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gauler & Associates, PLLC CurrentSince Oct 21, 2017 Accepting new patients

Locations

13111 Atlantic Blvd
Unit 2
Jacksonville, FL 32225
Phone (904) 239-3677

6950 Philips Hwy
Ste 11
Jacksonville, FL 32216
Phone (904) 239-3677

Organizations & group practices 3

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": "1130630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1619968716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 REYKO RD STE 100",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322072828",
            "telephone_number": "904-648-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 PHILIPS HWY STE 11",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-239-3677",
            "fax_number": "904-866-4029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2055 Reyko Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322072828",
            "country_code": "US",
            "telephone_number": "904-648-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SACKLOW",
        "first_name": "FRED",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-30",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.