Jim Branch, PH.D.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW0607 Issued in FL

Practice address

4319 S Ridgewood Ave
Port Orange, FL 32127-4522

Phone

(386) 451-5126

Fax

(386) 756-7518

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Core Counseling Service Inc

  • Clinical Social Worker
  • Port Orange, FL
  • NPI 1285791764
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629127345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4319 S RIDGEWOOD AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274522",
            "telephone_number": "386-451-5126",
            "fax_number": "386-756-7518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4319 S RIDGEWOOD AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274522",
            "telephone_number": "386-451-5126",
            "fax_number": "386-756-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANCH",
        "first_name": "JIM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW0607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Bowersox
• Margaret J. Bows, COTA
• Heather Leigh Bowyer, D.C.
• Brain and Spine Institute of Port Orange, LLC
• Brain Health Solutions, LLC
• Raynard Brant, RBT
• Beatrice Bratu, MD
• Breeze Aesthetics, Inc
• Teresa Brennan, D.C.
• Jacquelyn Tiffany Brenner, DPT

• Clinical Social Worker in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.