Active NPI
Hallel Saine
- Clinical Social Worker
- Jacksonville, FL
National Provider Identifier
1912654187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW21066
- Practice address
- 14546 Old Saint Augustine Rd Ste 317
Jacksonville, FL 32258-5472 - Phone
- (904) 260-9445
- Fax
- (904) 260-0005
- NPI assigned
- Mar 7, 2022
- Last updated
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | ISW15567 | FL | |
| Clinical Social Worker | 1041C0700X | SW21066 | FL | Primary |
Addresses
Primary practice location
14546 Old Saint Augustine Rd Ste 317
Jacksonville, FL 32258-5472
Mailing address
7015 A C Skinner Pkwy Ste 1
Jacksonville, FL 32256-6932
Phone (904) 363-2113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
66 E Flagler St
Miami, FL 33130-1807
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ISW15567 | FL | MD | Clinical Social Worker |
| SW21066 | FL | MD | Clinical Social Worker |
Organizations & group practices 1
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": "1646611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680134400000",
"number": "1912654187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7015 A C SKINNER PKWY STE 1",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322566932",
"telephone_number": "904-363-2113",
"fax_number": "904-363-2606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14546 OLD SAINT AUGUSTINE RD STE 317",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322585472",
"telephone_number": "904-260-9445",
"fax_number": "904-260-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAINE",
"first_name": "HALLEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-07",
"last_updated": "2023-03-30",
"certification_date": "2023-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "ISW15567",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW21066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.