Active NPI
Charles August Haasis, MSW
- Clinical Social Worker
- Jacksonville, FL
National Provider Identifier
1922027226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 19
- Practice address
- 1833 Boulevard
Jacksonville, FL 32206-4382 - Phone
- (904) 232-2751
- Fax
- (904) 232-3787
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 19 | FL | Primary |
Addresses
Primary practice location
1833 Boulevard
Jacksonville, FL 32206-4382
Mailing address
128 Patrick Mill Cir
Ponte Vedra Beach, FL 32082-4011
Phone (904) 232-2751
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW 19 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922027226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "128 PATRICK MILL CIR",
"city": "PONTE VEDRA BEACH",
"state": "FL",
"postal_code": "320824011",
"telephone_number": "904-232-2751",
"fax_number": "904-232-3787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1833 BOULEVARD",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322064382",
"telephone_number": "904-232-2751",
"fax_number": "904-232-3787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAASIS",
"first_name": "CHARLES",
"middle_name": "AUGUST",
"name_prefix": "Mr.",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 19",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.