Individual provider Active NPI

Shonsierae Brown, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1912399403
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11725 Issued in FL
Practice address
9951 Atlantic Blvd
Suite 158
Jacksonville, FL 32225-6584
Phone
(904) 386-8575
Fax
(904) 425-4688
NPI assigned
Feb 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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 SW11725 FL Primary

Addresses

Primary practice location

9951 Atlantic Blvd
Suite 158
Jacksonville, FL 32225-6584

Mailing address

1692 Hidden Forest LN
Jacksonville, FL 32225-5586
Phone (904) 386-8575

Other names 1

  • Mrs. Shon Brown Professional name

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
I20161110002519 FL Practitioner - Clinical Social Worker 3577842707 Reassigns benefits to 2 organizations
Practice locations: Jacksonville, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4720 Salisbury Rd
Jacksonville, FL 32256-6101
Phone (904) 318-2213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Assessment and Counseling Inc Clinical CurrentSince Sep 1, 2016 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": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1912399403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1692 HIDDEN FOREST LN",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322255586",
            "telephone_number": "904-386-8575",
            "fax_number": "904-425-4688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9951 ATLANTIC BLVD",
            "address_2": "SUITE 158",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322256584",
            "telephone_number": "904-386-8575",
            "fax_number": "904-425-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "SHONSIERAE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHON",
            "last_name": "BROWN",
            "prefix": "MRS.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.