Individual provider Active NPI

Jacqueline Nesci

  • Clinical Social Worker
  • Lake Park, FL
National Provider Identifier
1659914430
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11752 Issued in FL
Practice address
2818 Hinda Rd
Lake Park, FL 33403-1448
Phone
(561) 310-1147
NPI assigned
Oct 23, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X FL
Clinical Social Worker 1041C0700X
Clinical Social Worker 1041C0700X SW11752 FL Primary

Addresses

Primary practice location

2818 Hinda Rd
Lake Park, FL 33403-1448

Mailing address

2818 Hinda Rd
Lake Park, FL 33403-1448
Phone (561) 310-1147

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
I20201022002026 FL Practitioner - Clinical Social Worker 0941620447 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11752FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thriveworks Clinical - Florida Inc CurrentSince Oct 13, 2020 Accepting new patients

Locations

2425 E Commercial Blvd
Ste 405
Fort Lauderdale, FL 33308
Phone (754) 400-5514

1601 Belvedere Rd
Ste S204
West Palm Beach, FL 33406
Phone (561) 536-5293

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Interoperability endpoints

  • Direct secure messaging: jacqueline.nesci.1@9357.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1571788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571788800000",
    "number": "1659914430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2818 HINDA RD",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334031448",
            "telephone_number": "561-310-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2818 HINDA RD",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334031448",
            "telephone_number": "561-310-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NESCI",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-23",
        "last_updated": "2019-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Park, FL

Sources for this page

Verify at the official NPI Registry.