A Safe Place Behavioral Health

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

A SAFE PLACE BEHAVIORAL HEALTH

Practice address

10151 Deerwood Park Blvd
200-250
Jacksonville, FL 32256

Phone

(904) 479-6494

NPI assigned

Apr 27, 2022

Last updated

Apr 27, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kimberly AndreNPI 1811515604

Title

Manager/Clinical Social Worker

Phone

(305) 904-6565

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kimberly Andre, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1811515604
  NPD Authorized official

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

{
    "created_epoch": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1689318321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD",
            "address_2": "200-250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-479-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10151 DEERWOOD PARK BLVD",
            "address_2": "200-250",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32256",
            "telephone_number": "904-479-6494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A SAFE PLACE BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "ANDRE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "MANAGER/CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "305-904-6565"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, 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 Apr 27, 2022; 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.