Individual provider Active NPI

Jeannan Haygood

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1982024006
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14149 Issued in FL
Practice address
145 Heron Bay Rd
Jacksonville, FL 32218-3595
Phone
(813) 966-3030
NPI assigned
Apr 16, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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 SW14149 FL Primary

Addresses

Primary practice location

145 Heron Bay Rd
Jacksonville, FL 32218-3595

Mailing address

6001 Argyle Forest Blvd Ste 21
Jacksonville, FL 32244-6127
Phone (813) 966-3030

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
I20170915000657 FL Practitioner - Clinical Social Worker 6901170893 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)

Jacksonville, FL 32244
Phone (813) 966-3030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14149FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Enrich Counseling Services LLC Clinical CurrentSince Jun 18, 2023 Accepting new patients

Locations

6001 Argyle Forest Blvd
Ste 21
Jacksonville, FL 32244
Phone (888) 395-0026

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1982024006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6001 ARGYLE FOREST BLVD STE 21",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322446127",
            "telephone_number": "813-966-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 HERON BAY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183595",
            "telephone_number": "813-966-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYGOOD",
        "first_name": "JEANNAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-16",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.