Active NPI
Kristen Cleary, LCSW
- Clinical Social Worker
- Green Cove Springs, FL
National Provider Identifier
1932500535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW13928
- Practice address
- 623 Oak St
Green Cove Springs, FL 32043-4313 - Phone
- (904) 531-5152
- NPI assigned
- Sep 15, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | SW13928 | FL | Primary |
| School Social Worker | 1041S0200X | 73-079587 | NY |
Addresses
Primary practice location
623 Oak St
Green Cove Springs, FL 32043-4313
Mailing address
540 Reberry Lane
Saint Johns, FL 32259
Phone (845) 260-0571
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 |
|---|---|---|---|
| SW13928 | FL | MD | Clinical Social Worker |
| 73-079587 | NY | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410739200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479254400000",
"number": "1932500535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "540 REBERRY LANE",
"city": "SAINT JOHNS",
"state": "FL",
"postal_code": "32259",
"telephone_number": "845-260-0571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "623 OAK ST",
"city": "GREEN COVE SPRINGS",
"state": "FL",
"postal_code": "320434313",
"telephone_number": "904-531-5152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEARY",
"first_name": "KRISTEN",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-15",
"last_updated": "2016-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW13928",
"primary": true
},
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NY",
"license": "73-079587",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Green Cove Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.