Healthcare Provider Details

I. General information

NPI: 1811533920
Provider Name (Legal Business Name): JAMIE ALEXANDRA LANDSMAN MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE A LANDSMAN MSW, LCSW

II. Dates (important events)

Enumeration Date: 11/24/2019
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11607 GROVE ARCADE DR
RIVERVIEW FL
33569-5591
US

IV. Provider business mailing address

11607 GROVE ARCADE DR
RIVERVIEW FL
33569-5591
US

V. Phone/Fax

Practice location:
  • Phone: 732-503-9330
  • Fax:
Mailing address:
  • Phone: 732-503-9330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW23194
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number229832
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW027541
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number113820
License Number StateTX
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06047800
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP00946870
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: