Individual provider Active NPI

Jonathan Belolo, LCSW

  • Clinical Social Worker
  • Boca Raton, FL
National Provider Identifier
1679181507
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14356 Issued in FL
Practice address
4400 N Federal Hwy Ste 210-18
Boca Raton, FL 33431-5187
Phone
(561) 464-6229
NPI assigned
Jul 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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 SW14356 FL Primary

Addresses

Primary practice location

4400 N Federal Hwy Ste 210-18
Boca Raton, FL 33431-5187

Mailing address

4400 N Federal Hwy Ste 210-18
Boca Raton, FL 33431-5187
Phone (561) 464-6229

Other practice location 1

6875 Bridlewood Ct
Boca Raton, FL 33433-3558
Phone (561) 789-9359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 2, 2025 through May 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW14356FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1679181507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 N FEDERAL HWY STE 210-18",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334315187",
            "telephone_number": "561-464-6229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N FEDERAL HWY STE 210-18",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334315187",
            "telephone_number": "561-464-6229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6875 Bridlewood Ct",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334333558",
            "country_code": "US",
            "telephone_number": "561-789-9359",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BELOLO",
        "first_name": "JONATHAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-16",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.