Positive Strides LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

POSITIVE STRIDES LLC

Practice address

10139 Beach Port Dr
Winter Garden, FL 34787-4413

Phone

(678) 472-8964

Fax

(404) 487-8907

NPI assigned

Sep 2, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aishah BoodramNPI 1689052813

Title

LCSW

Phone

(678) 472-8964

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aishah Boodram, LCSW

  • Clinical Social Worker
  • Winter Garden, FL
  • NPI 1689052813
  Medicare reassignment Authorized official
• Shainna Bey, LCSW

  • Clinical Social Worker
  • Winter Garden, FL
  • NPI 1003481748
  NPD (past)

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586995200000",
    "number": "1982151338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10139 BEACH PORT DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874413",
            "telephone_number": "678-472-8964",
            "fax_number": "404-487-8907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10139 BEACH PORT DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347874413",
            "telephone_number": "678-472-8964",
            "fax_number": "404-487-8907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE STRIDES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-02",
        "last_updated": "2020-04-16",
        "certification_date": "2020-04-16",
        "status": "A",
        "authorized_official_last_name": "BOODRAM",
        "authorized_official_first_name": "AISHAH",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "678-472-8964"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.