Individual provider Active NPI

Chevalene Sherai Palmer Barnes, LCSW

  • Clinical Social Worker
  • Plantation, FL
National Provider Identifier
1790154797
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9162 Issued in FL
Practice address
1121 NW 111TH Ave
Plantation, FL 33322-7826
Phone
(954) 826-5979
NPI assigned
Sep 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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 SW9162 FL Primary

Addresses

Primary practice location

1121 NW 111TH Ave
Plantation, FL 33322-7826

Mailing address

1121 NW 111TH Ave
Plantation, FL 33322-7826
Phone (954) 826-5979

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
I20151229002615 FL Practitioner - Clinical Social Worker 0042512535 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW9162FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bold Freedom LLC Clinical CurrentSince Jun 21, 2020 Accepting new patients

Organizations & group practices 2

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": "1442707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1790154797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 NW 111TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333227826",
            "telephone_number": "954-826-5979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 NW 111TH AVE",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333227826",
            "telephone_number": "954-826-5979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER BARNES",
        "first_name": "CHEVALENE",
        "middle_name": "SHERAI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-20",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plantation, FL

Sources for this page

Verify at the official NPI Registry.