Edwin Hannah, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

ISW14479 Issued in FL

Practice address

43 Knight Boxx Rd Ste 1
Orange Park, FL 32065-7395

Phone

(904) 379-8675

Fax

(904) 423-0490

NPI assigned

Feb 21, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

River'S Edge Counseling PLLCGroup PAC ID 3577844091, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• River'S Edge Counseling, PLLC

  • Mental Health Counselor
  • Orange Park, FL
  • NPI 1396155768
  Medicare reassignment Care Compare group
• River'S Edge Counseling, PLLC

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1548958168

  Clinical

  NPD

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1689207243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 KNIGHT BOXX RD STE 1",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657395",
            "telephone_number": "904-379-8675",
            "fax_number": "904-423-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 KNIGHT BOXX RD STE 1",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320657395",
            "telephone_number": "904-379-8675",
            "fax_number": "904-423-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNAH",
        "first_name": "EDWIN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW14479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Larry L Han, AP
• Kellie John Handscombe, DPT
• Hanger Prosthetics & Orthotics Inc
• Zainab Hanif, M.D.
• Amanda Hannah, LMHC
• Haley Hannah
• Mary Ann Hanson, APRN
• Nicholas Hanson, PHARMD
• Harbor Physicians LLC
• Jasmine Seara Hardaway, RN

• Clinical Social Worker in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.