Individual provider Active NPI

Susan Evelyn Shafran, LCSW

  • Clinical Social Worker
  • Pompano Beach, FL
National Provider Identifier
1699788596
Registry record updated Sep 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10445 Issued in FL
Practice address
1371 S Ocean Blvd
Pompano Beach, FL 33062-7130
Phone
(954) 943-1155
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 073494 NY
Clinical Social Worker 1041C0700X 078572 NY
Clinical Social Worker 1041C0700X SW10445 FL Primary

Addresses

Primary practice location

1371 S Ocean Blvd
Pompano Beach, FL 33062-7130

Mailing address

5851 Holmberg Rd
Apt 2013
Parkland, FL 33067-4536
Phone (718) 314-5450

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121206000130 FL Practitioner - Clinical Social Worker 2264618826 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW10445FLMDClinical Social Worker
078572NYMDClinical Social Worker
073494NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa Friedman L C S W Inc Clinical CurrentSince Jan 14, 2019 Accepting new patients
Medication Assisted Recovery Institute, LLC Clinical CurrentSince Aug 19, 2020 Accepting new patients
Mindpath Health Florida, PLLC Clinical CurrentSince Sep 18, 2019 Accepting new patients
Irecovery, LLC Clinical Current Accepting new patients
Irecovery, LLC Clinical CurrentSince Aug 19, 2020 Accepting new patients
Family and Children'S Association - Linkage Past Accepting new patients

Locations

5030 Champion Blvd
Ste G11535
Boca Raton, FL 33496

5030 Champion Blvd
Ste G11
Boca Raton, FL 33496

2900 N Military Trl
Ste 241
Boca Raton, FL 33431
Phone (561) 464-4949

1725 N University Dr
Ste 350
Coral Springs, FL 33071
Phone (954) 227-2700

130 S Indian River Dr
Ste 2026405
Fort Pierce, FL 34950
Phone (772) 773-6989

9715 W Broward Blvd
Plantation, FL 33324
Phone (954) 741-1099

7376 NW 5th St
Plantation, FL 33317
Phone (954) 461-5690

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346803200000",
    "number": "1699788596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5851 HOLMBERG RD",
            "address_2": "APT 2013",
            "city": "PARKLAND",
            "state": "FL",
            "postal_code": "330674536",
            "telephone_number": "718-314-5450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1371 S OCEAN BLVD",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330627130",
            "telephone_number": "954-943-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFRAN",
        "first_name": "SUSAN",
        "middle_name": "EVELYN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2012-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "073494",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078572",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompano Beach, FL

Sources for this page

Verify at the official NPI Registry.