Individual provider Active NPI

Michael Doyle Love, LCSW

  • Clinical Social Worker
  • Fort Sam Houston, TX
National Provider Identifier
1841663143
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW18946 Issued in FL
Practice address
Brooke Army Medical Center
3551 Roger Brooke Drive
Fort Sam Houston, TX 78234
Phone
(210) 557-6916
NPI assigned
Nov 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X SW18946 FL
Mental Health Counselor 101YM0800X SW18946 FL
Clinical Social Worker 1041C0700X SW18946 FL Primary

Addresses

Primary practice location

Brooke Army Medical Center
3551 Roger Brooke Drive
Fort Sam Houston, TX 78234

Mailing address

14325 Falconhead Dr
Jacksonville, FL 32224-2850
Phone (904) 533-5537

Other practice location 1

14325 Falconhead Dr
Jacksonville, FL 32224-2850
Phone (904) 562-0941

Other practice location 2

13245 Atlantic Blvd Ste 4-317
Jacksonville, FL 32225-7121
Phone (049) 533-5537

Other identifiers 1

IdentifierTypeStateIssuer
57-3209933OtherFLMALCOLM RANDALL VAMC

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
I20211208003676 FL Practitioner - Clinical Social Worker 9830589753 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW18946FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Help Me to Help You Counseling LLC CurrentSince Apr 15, 2023 Accepting new patients
Pine Castle Inc. CurrentSince Nov 1, 2021 Accepting new patients
Clay Physical Therapy PA PastSince Nov 1, 2021 Accepting new patients
Right Path Behavioral Health Services, LLC. Past Accepting new patients

Locations

4911 Spring Park Rd
Jacksonville, FL 32207
Phone (904) 269-7751

Organizations & group practices 4

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": "1447027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727308800000",
    "number": "1841663143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14325 FALCONHEAD DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322242850",
            "telephone_number": "904-533-5537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BROOKE ARMY MEDICAL CENTER",
            "address_2": "3551 ROGER BROOKE DRIVE",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-557-6916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14325 Falconhead Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322242850",
            "country_code": "US",
            "telephone_number": "904-562-0941",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13245 Atlantic Blvd Ste 4-317",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322257121",
            "country_code": "US",
            "telephone_number": "049-533-5537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOVE",
        "first_name": "MICHAEL",
        "middle_name": "DOYLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-09",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "SW18946",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW18946",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MALCOLM RANDALL VAMC",
            "identifier": "57-3209933",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

Verify at the official NPI Registry.