Individual provider Active NPI

Kristen Doodian, LCSW

  • Clinical Social Worker
  • Lake Worth, FL
National Provider Identifier
1669908844
Registry record updated May 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13682 Issued in FL
Practice address
3898 Via Poinciana
Suite 13
Lake Worth, FL 33467-2951
Phone
(561) 967-2566
NPI assigned
May 5, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2017

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 SW13682 FL Primary

Addresses

Primary practice location

3898 Via Poinciana
Suite 13
Lake Worth, FL 33467-2951

Mailing address

3898 Via Poinciana
Suite 13
Lake Worth, FL 33467-2951
Phone (561) 967-2566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW13682FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493942400000",
    "number": "1669908844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3898 VIA POINCIANA",
            "address_2": "SUITE 13",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672951",
            "telephone_number": "561-967-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3898 VIA POINCIANA",
            "address_2": "SUITE 13",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334672951",
            "telephone_number": "561-967-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOODIAN",
        "first_name": "KRISTEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-05",
        "last_updated": "2017-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; 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.