Individual provider Active NPI

Leah M Pavela-Mullins, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1013017789
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7224 Issued in FL
Practice address
2808 NE 22ND St
Fort Lauderdale, FL 33305-2804
Phone
(954) 664-9460
Fax
(954) 564-1371
NPI assigned
Sep 23, 2006
Sex
Female
Sole proprietor
No

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 SW7224 FL Primary

Addresses

Primary practice location

2808 NE 22ND St
Fort Lauderdale, FL 33305-2804

Mailing address

2808 NE 22ND St
Fort Lauderdale, FL 33305-2804
Phone (954) 664-9460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, KY2 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

Enrollment IDStateProvider typePAC IDDetails
I20060406000319 FL Practitioner - Clinical Social Worker 7315956158 Reassigns benefits to 1 organization
I20260622003399 KY Practitioner - Clinical Social Worker 7315956158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 California St
Suite 2300
San Francisco, CA 94111-3720

1 California St
Suite 2300
San Francisco, CA 94111-5424

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Doctor on Demand Professionals P C CurrentSince Jul 16, 2020 Accepting new patients

Locations

1 California St
Ste 2300
San Francisco, CA 94111
Phone (800) 929-0926

1201 Hays St
Tallahassee, FL 32301
Phone (855) 522-7233

Interoperability endpoints

  • Direct secure messaging: leah.pavela-mullins.1@30520.direct.athenahealth.com
  • Direct secure messaging: leahpavelamullins@tdh.allscriptsdirect.net

Organizations & group practices 2

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": "1158969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1013017789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 NE 22ND ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333052804",
            "telephone_number": "954-664-9460",
            "fax_number": "954-564-1371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 NE 22ND ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333052804",
            "telephone_number": "954-664-9460",
            "fax_number": "954-564-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVELA-MULLINS",
        "first_name": "LEAH",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

Verify at the official NPI Registry.