Active NPI
Jasminet Pathak, LCSW
- Clinical Social Worker
- Fort Myers, FL
National Provider Identifier
1669915757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 14056
- Practice address
- 12550 New Brittany Blvd
Fort Myers, FL 33907-3655 - Phone
- (239) 343-9180
- Fax
- (239) 343-9188
- NPI assigned
- Nov 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 14056 | FL | Primary |
Addresses
Primary practice location
12550 New Brittany Blvd
Fort Myers, FL 33907-3655
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9180
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW 14056 | FL | MD | Clinical Social Worker |
Practice roles (2 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regency Rehab Center | Past | Accepting new patients | |
| Shalaish Pathak | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 2
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.
-
- Rehabilitation Clinic/Center
- Houston, TX
- NPI 1700853181
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Houston, TX
- NPI 1770792061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579564800000",
"number": "1669915757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-343-9180",
"fax_number": "239-343-9188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12550 NEW BRITTANY BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339073655",
"telephone_number": "239-343-9180",
"fax_number": "239-343-9188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATHAK",
"first_name": "JASMINET",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-22",
"last_updated": "2020-01-21",
"certification_date": "2020-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 14056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.