Organization Active NPI

Carole Flaster LCSW PA

  • Marriage & Family Therapist
  • Davie, FL
National Provider Identifier
1659646453
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT415 Issued in FL
Legal business name
CAROLE FLASTER LCSW PA
Practice address
5400 S University Drive
Suite 207
Davie, FL 33328-5309
Phone
(954) 370-3335
Fax
(954) 370-3353
NPI assigned
Mar 13, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Carole FlasterNPI 1144252982
Title
Owner
Phone
(954) 370-3335

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X SW850 FL
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X MT415 FL Primary

Addresses

Primary practice location

5400 S University Drive
Suite 207
Davie, FL 33328-5309

Mailing address

5400 S University Drive
Suite 207
Davie, FL 33328-5309
Phone (954) 370-3335

Other identifiers 4

IdentifierTypeStateIssuer
000900000MedicaidFL
217790OtherFLAVMED
029638OtherFLVALULE OPTIONS
Z-1041OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121105000227 FL Part B Supplier - Clinic/Group Practice 0840441606 Receives reassigned benefits from 1 practitioner
Practice locations: Davie, FL

National Provider Directory

National Provider Directory
Tax ID family
Carole Flaster2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12555 Orange Dr
Ste 111
Davie, FL 33330
Phone (954) 862-1482

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1659646453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DRIVE",
            "address_2": "SUITE 207",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285309",
            "telephone_number": "954-370-3335",
            "fax_number": "954-370-3353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S UNIVERSITY DRIVE",
            "address_2": "SUITE 207",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333285309",
            "telephone_number": "954-370-3335",
            "fax_number": "954-370-3353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLE FLASTER LCSW PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "FLASTER",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-370-3335"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW850",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000900000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "217790",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALULE OPTIONS",
            "identifier": "029638",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z-1041",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.