JAE J. PATE (NPI# 1356315600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356315600 |
| Entity Type | Individual |
| Full Name | JAE J. PATE |
| Credential | LCSW |
| Practice Address |
340 Magnolia Circle 325 Mdos/sgohsf Tyndall Afb FL 32404 |
| Mailing Address |
325 Mdos/sgohsf Tyndall Afb FL 32404 |
| Practice Telephone | 8502837511 |
| Practice Fax Number | 8502837721 |
| Mailing Telephone | 8502837511 |
| Mailing Fax Number | 8502837721 |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
0002390 | FL | Behavioral Health & Social Service Providers |
| Street Address |
340 MAGNOLIA CIRCLE 325 MDOS/SGOHSF |
| City | TYNDALL AFB |
| State | FL |
| Zip Code | 32404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326463639 | Latasha Johnson | Family Medicine | 340 Magnolia Circle, 325 Mdg, Tyndall Afb, FL 32403-5250 | 2014-02-24 |
| 1700192531 | Keisha Monice Vilsaint | Nurse Practitioner | 340 Magnolia Circle, 325th Mdos/ 325th Medical Group Treatment Facility, Tyndall Afb, FL 32403-5612 | 2010-08-31 |
| 1831155233 | Michael Rutledge Frayser | Family Medicine | 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2006-04-25 |
| 1285600437 | Kimberly Susan Johnson | Pediatrics | 340 Magnolia Circle, Tyndall Afb, FL 32403-5612 | 2006-02-27 |
| 1053387548 | Patricia Anne Smith | Nurse Practitioner | 340 Magnolia Circle, 325 Medical Group/sgomf, Tyndall Afb, FL 32403-5300 | 2006-02-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508278854 | Wayne Harris | Non-emergency Medical Transport (VAN) | 4826 Mccall Ln, Panama City, FL 32404 | 2014-05-21 |
| 1417384769 | Yolanda M Tingler | Social Worker | 7334 Highway 2311, Panama City, FL 32404 | 2013-10-02 |
| 1326482381 | Lydia Ann Rosenberger | Nurse Practitioner | 3520 East 15th Streett, Panama City, FL 32404 | 2013-04-22 |
| 1114288651 | Carly D Taulbee | Physical Therapy Assistant | 626 S Tyndall Pkwy, Panama City, FL 32404 | 2012-05-31 |
| 1770855934 | Lavie Rehab | Skilled Nursing Facility | 636 Tyndall Pkwy, Panama City, FL 32404 | 2012-02-03 |
| 1760695431 | Corey J Seymour | Military Health Care Provider | 4837 Mccall Ln, Panama City, FL 32404 | 2007-05-08 |
| 1336361625 | Vicky Perkins Whitfield | Pharmacist | 3621 Us Hwy 231 N., Panama City, FL 32404 | 2007-05-03 |
| 1528280807 | John Charles Peacock Sr. | Pharmacist | 3621 Us Hwy 231 North, Panama City, FL 32404 | 2007-05-03 |
| 1184782906 | Shelley Isenberg Hickman | Occupational Therapist | 5441 Nehi Rd, Panama City, FL 32404 | 2006-12-05 |
| 1629151931 | Kenneth Michael Plumley | Physician Assistant | 5620 Cherry St, Callaway, FL 32404 | 2006-10-23 |
| Find all providers in zip 32404 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982260519 | Michelle Camille Lasater | Social Worker | 340 Magnolia Cir Bldg 1309, Tyndall Afb, FL 32403-5612 | 2019-05-20 |
| 1093737272 | Walter Edward Calvo | Social Worker | Bldg 1305 Suwannee Ave, Tyndall Afb, FL 32403 | 2006-07-24 |
| 1619488806 | Clairissa Bradford | Social Worker | 340 Magnolia Cir, Tyndall Afb, FL 32403-5604 | 2017-10-16 |
| 1093053282 | Melissa Brooks Smith | Social Worker | 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403-5604 | 2013-01-22 |
| 1497951917 | Heather Danielle Bautista | Social Worker | 340 Magnolia Cir, Tyndall Afb, FL 32403-5604 | 2007-06-22 |
| 1306905211 | Xhosa R Burford | Social Worker | 340 Magnolia Cir, Tyndall Afb, FL 32403 | 2006-12-06 |
| 1821103532 | Brett A. Rash | Social Worker | 325th Medical Group, 340 Magnolia Circle, Bldg. 1465, Tyndall Afb, FL 32403-5604 | 2006-08-20 |
| 1548251465 | Gabrielle Kelly Blankenship | Social Worker | 325 Mdg, 340 Magnolia Circle, Tyndall Afb, FL 32403 | 2005-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679303 | Kamarie Lee Larson | Social Worker | 913 Gulf Breeze Pkwy Ste 26b, Gulf Breeze, FL 32561-4731 | 2020-11-08 |
| 1023619772 | Nichole Goff | Social Worker | 12151 Waterstone Ct Apt 826, Orlando, FL 32825-7035 | 2020-11-07 |
| 1356942262 | Shirley Roseman | Social Worker | 1450 E Sample Rd Apt 101, Pompano Beach, FL 33064-6267 | 2020-11-06 |
| 1760083729 | Phoenix Marie Klemann | Social Worker | 3311 Mona Dr, Navarre, FL 32566-9742 | 2020-11-05 |
| 1679174726 | Violett Counseling & Consulting Services LLC | Social Worker | 30 Wisteria Dr, Ormond Beach, FL 32176-2408 | 2020-11-05 |
| 1336740422 | Marissa Pinto | Social Worker | 3642 Eldron Ave, North Port, FL 34286-7453 | 2020-11-04 |
| 1710588991 | Mario Jesus Noguera | Social Worker | 18179 Nw 73rd Ave, Hialeah, FL 33015-6198 | 2020-11-04 |
| 1801497185 | Andrey Davydov | Social Worker | 3800 N Hills Dr Apt 106, Hollywood, FL 33021-2541 | 2020-11-04 |
| 1902407299 | Beverly Diane Sweeting | Social Worker | 10961 Sw Ivory Springs Ln, Port St Lucie, FL 34987-7710 | 2020-11-04 |
| 1174124622 | Cardinal Counseling Services, LLC | Social Worker | 2161 16th Ave Sw, Naples, FL 34117-4338 | 2020-11-02 |
| Find all providers with the same taxonomy | ||||
| City | TYNDALL AFB |
| Zip Code | 32404 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.