Individual provider Active NPI

Jessica Ann-Marie Clemente, LCSW

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1033432745
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 9421 Issued in FL
Practice address
5730 Lake Underhill Rd
Orlando, FL 32807-4366
Phone
(407) 322-8645
Fax
(407) 487-3418
NPI assigned
Mar 9, 2010
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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 SW 9421 FL Primary

Addresses

Primary practice location

5730 Lake Underhill Rd
Orlando, FL 32807-4366

Mailing address

4930 E Lake Mary Blvd
Sanford, FL 32771-5003
Phone (407) 322-8645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240125001530 FL Practitioner - Clinical Social Worker 5597118646

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 9421FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1033432745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4930 E LAKE MARY BLVD",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327715003",
            "telephone_number": "407-322-8645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5730 LAKE UNDERHILL RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328074366",
            "telephone_number": "407-322-8645",
            "fax_number": "407-487-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "JESSICA",
        "middle_name": "ANN-MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-09",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 9421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.