Individual provider Active NPI

Eder Petit-Clair, LCSW

  • Clinical Social Worker
  • N Miami Beach, FL
National Provider Identifier
1881323582
Registry record updated Jun 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
19430 Issued in FL
Practice address
2025 NE 164TH St Apt 1009
N Miami Beach, FL 33162-4162
Phone
(786) 277-7793
NPI assigned
Jun 8, 2022
Last updated
Jun 8, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2022

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 19430 FL Primary

Addresses

Primary practice location

2025 NE 164TH St Apt 1009
N Miami Beach, FL 33162-4162

Mailing address

PO Box 600202
North Miami Beach, FL 33160-0202
Phone (786) 277-7793

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
I20221012003456 FL Practitioner - Clinical Social Worker 3173999372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
A and B Counseling Services LLCGroup PAC ID 6103152269, 73 clinicians

Practice addresses (Care Compare)

3356 Laurel Oak St
Fort Lauderdale, FL 33312-6396
Phone (954) 533-2306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19430FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
A & B Counseling Services LLC CurrentSince Aug 1, 2022 Accepting new patients
A & B Counseling LLC 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1881323582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 600202",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331600202",
            "telephone_number": "786-277-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 NE 164TH ST APT 1009",
            "city": "N MIAMI BEACH",
            "state": "FL",
            "postal_code": "331624162",
            "telephone_number": "786-277-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETIT-CLAIR",
        "first_name": "EDER",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "19430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in N Miami Beach, FL

Sources for this page

Verify at the official NPI Registry.