Active NPI
Kerri Hotlen
- Clinical Social Worker
- Daytona Beach, FL
National Provider Identifier
1770925646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW14878
- Practice address
- 1220 Willis Ave
Daytona Beach, FL 32114-2810 - Phone
- (800) 538-4228
- NPI assigned
- Jul 22, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Clinical Social Worker | 1041C0700X | 6801094849 | MI | |
| Clinical Social Worker | 1041C0700X | SW14878 | FL | Primary |
Addresses
Primary practice location
1220 Willis Ave
Daytona Beach, FL 32114-2810
Mailing address
3865 S Mackinac TRL
Sault Sainte Marie, MI 49783-9286
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 |
|---|---|---|---|
| SW14878 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510876800000",
"number": "1770925646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3865 S MACKINAC TRL",
"city": "SAULT SAINTE MARIE",
"state": "MI",
"postal_code": "497839286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1220 WILLIS AVE",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321142810",
"telephone_number": "800-538-4228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOTLEN",
"first_name": "KERRI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-22",
"last_updated": "2017-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801094849",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW14878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Daytona Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.