Individual provider Active NPI

Laura Bonczek, LCSW

  • Clinical Social Worker
  • North Miami Beach, FL
National Provider Identifier
1790051852
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14109 Issued in FL
Practice address
150 NW 168TH St Ste 200
North Miami Beach, FL 33169-6034
Phone
(877) 723-7117
NPI assigned
Mar 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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 SW14109 FL Primary

Addresses

Primary practice location

150 NW 168TH St Ste 200
North Miami Beach, FL 33169-6034

Mailing address

150 NW 168TH St Ste 200
North Miami Beach, FL 33169-6034
Phone (877) 723-7117

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW14109FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1790051852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NW 168TH ST STE 200",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331696034",
            "telephone_number": "877-723-7117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 NW 168TH ST STE 200",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331696034",
            "telephone_number": "877-723-7117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONCZEK",
        "first_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-22",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.