Individual provider Active NPI

Susan E. Kurner, LCSW

  • Professional Counselor
  • Jacksonville, FL
National Provider Identifier
1801842679
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
SW7995 Issued in FL
Practice address
10149 Fox Lake CT
Jacksonville, FL 32219-1693
Phone
(352) 494-6857
Fax
(888) 346-3643
NPI assigned
May 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X SW7995 FL
Addiction (Substance Use Disorder) Counselor 101YA0400X SW7995 FL
Mental Health Counselor 101YM0800X SW7995 FL
School Counselor 101YS0200X SW7995 FL
Social Worker 104100000X SW7995 FL
Clinical Social Worker 1041C0700X SW7995 FL
Professional Counselor 101YP2500X SW7995 FL Primary

Addresses

Primary practice location

10149 Fox Lake CT
Jacksonville, FL 32219-1693

Mailing address

10149 Fox Lake CT
Jacksonville, FL 32219-1693
Phone (352) 494-6857

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
I20050929000386 FL Practitioner - Clinical Social Worker 6800821711 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Florida Assessment and Counseling IncGroup PAC ID 8426235953, 3 clinicians

Practice addresses (Care Compare)

Jacksonville, FL 32219
Phone (352) 494-6857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW7995FLMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Assessment and Counseling Inc Counselor CurrentSince May 1, 2011 Accepting new patients
Care 4 America Inc Mental Health Past 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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1801842679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10149 FOX LAKE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322191693",
            "telephone_number": "352-494-6857",
            "fax_number": "888-346-3643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10149 FOX LAKE CT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322191693",
            "telephone_number": "352-494-6857",
            "fax_number": "888-346-3643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURNER",
        "first_name": "SUSAN",
        "middle_name": "E.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-25",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "SW7995",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "SW7995",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW7995",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "FL",
            "license": "SW7995",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW7995",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7995",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "SW7995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.