Benjamin Kyle Hancock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16191 Issued in FL

Practice address

3810-3 Williamsburg Park Blvd
Jacksonville, FL 32257-9220

Phone

(904) 419-6102

Fax

(904) 739-2153

NPI assigned

Mar 25, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL, NC2 enrollments

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 2

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mandarin Counseling IncGroup PAC ID 0143397281, 5 clinicians

Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  NC

  Medicare reassignment Care Compare group NPD
• Mandarin Counseling Inc

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1811187271
  Medicare reassignment Care Compare group NPD
• Balanced Wellbeing LLC

  • Psychiatry Physician
  • Ocala, FL
  • NPI 1336513639

  Clinical

  Medicare reassignment NPD
• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment NPD
• Breakthroughs Counseling & Recovery

  • Clinical Social Worker
  • Jacksonville, FL
  • NPI 1033133616

  Mental Health

  NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• Breakthroughs Counseling and Recovery Inc.

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1568861516
  NPD (past)

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1992332373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810-3 WILLIAMSBURG PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322579220",
            "telephone_number": "904-419-6102",
            "fax_number": "904-739-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810-3 WILLIAMSBURG PARK BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322579220",
            "telephone_number": "904-419-6102",
            "fax_number": "904-739-2153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668752",
            "country_code": "US",
            "telephone_number": "863-494-1242",
            "fax_number": "863-491-0466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "BENJAMIN",
        "middle_name": "KYLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW16191",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "SW16191",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "erika@breakthroughsIOP.com",
            "affiliation": "N",
            "endpointDescription": "PM email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3810-3 Williamsburg Park Blvd",
            "city": "Jacksonville",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322579220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hanasa Nursing LLC
• Rachel Watford Hanberry, MS CCC-SLP
• Kunal Krishna Hanchate, MD
• Ashley Hancock
• Autumn M Hancock, APRN
• Holly Louise Hancock, MD
• Kevin John Hancock, M.D.
• Linda L Hancock, CNP
• Michael Erle Hancock, RBT, MA
• Hand & Hand Companion Services LLC

• Clinical Social Worker in Jacksonville, FL
• Providers in Jacksonville, 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 Feb 3, 2022; 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.

Verify at the official NPI Registry.