Individual provider Active NPI

Jennifer Van Berkum, LCSW

  • Clinical Social Worker
  • Panama City, FL
National Provider Identifier
1821972738
Registry record updated Jul 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW24404 Issued in FL
Practice address
280 Forest Park Cir
Panama City, FL 32405-4919
Phone
(850) 273-5433
NPI assigned
Aug 4, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2026

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 LC25795 ME
Clinical Social Worker 1041C0700X SW24404 FL Primary
Clinical Social Worker 1041C0700X 6668C AL

Addresses

Primary practice location

280 Forest Park Cir
Panama City, FL 32405-4919

Mailing address

280 Forest Park Cir
Panama City, FL 32405-4919
Phone (850) 273-5433

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
I20250910003024 FL Practitioner - Clinical Social Worker 4385147966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

525 E 15TH St
Panama City, FL 32405-5412

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6668CALMDClinical Social Worker
SW24404FLMDClinical Social Worker
LC25795MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Management Center of Northwest Florida Inc CurrentSince Aug 12, 2025 Accepting new patients
Life Management Center of NW FL, Inc. CurrentSince Aug 12, 2025 Accepting new patients

Locations

525 E 15th St
Panama City, FL 32405
Phone (850) 522-4485

Organizations & group practices 3

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": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784332800000",
    "number": "1821972738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 FOREST PARK CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054919",
            "telephone_number": "850-273-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 FOREST PARK CIR",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324054919",
            "telephone_number": "850-273-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BERKUM",
        "first_name": "JENNIFER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2026-07-18",
        "certification_date": "2026-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC25795",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW24404",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "6668C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City, FL

Sources for this page

Verify at the official NPI Registry.