Individual provider Active NPI

Jasmine Lane, LCSW

  • Clinical Social Worker
  • Lakeland, FL
National Provider Identifier
1912177312
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12433 Issued in FL
Practice address
2033 E Edgewood Dr Ste 4
Lakeland, FL 33803-3660
Phone
(863) 968-6348
NPI assigned
Mar 3, 2008
Last updated
Feb 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC10013 ME
Clinical Social Worker 1041C0700X SW12433 FL Primary

Addresses

Primary practice location

2033 E Edgewood Dr Ste 4
Lakeland, FL 33803-3660

Mailing address

620 W Shady LN
Lakeland, FL 33803-2052
Phone (863) 968-6348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW12433FLMDClinical Social Worker
LC10013MEMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1912177312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 W SHADY LN",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338032052",
            "telephone_number": "863-968-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2033 E EDGEWOOD DR STE 4",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338033660",
            "telephone_number": "863-968-6348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "JASMINE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-03",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC10013",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.