Individual provider Active NPI

Valencia L Campbell, LCSW, LICSW

  • Clinical Social Worker
  • Port St Lucie, FL
National Provider Identifier
1033950233
Registry record updated Oct 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW22994 Issued in FL
Practice address
1622 SW Realty St
Port St Lucie, FL 34987-2226
Phone
(772) 446-1443
NPI assigned
Jun 3, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW128199 MA
Clinical Social Worker 1041C0700X SW22994 FL Primary
Clinical Social Worker 1041C0700X ID
Clinical Social Worker 1041C0700X 0904018777 VA
Clinical Social Worker 1041C0700X 34826 MN

Addresses

Primary practice location

1622 SW Realty St
Port St Lucie, FL 34987-2226

Mailing address

4371 Trevi CT
Lake Worth, FL 33467-4082
Phone (772) 446-1443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, FL, MN, DC, ID, RI6 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 6

Enrollment IDStateProvider typePAC IDDetails
I20241017000974 MA Practitioner - Clinical Social Worker 6204368038 Reassigns benefits to 1 organization
I20241017003254 FL Practitioner - Clinical Social Worker 6204368038 Reassigns benefits to 1 organization
I20250630001076 MN Practitioner - Clinical Social Worker 6204368038 Reassigns benefits to 1 organization
I20250729001066 DC Practitioner - Clinical Social Worker 6204368038 Reassigns benefits to 1 organization
I20250903003015 ID Practitioner - Clinical Social Worker 6204368038 Reassigns benefits to 1 organization
I20260407001169 RI Practitioner - Clinical Social Worker 6204368038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LICSW128199MAMDClinical Social Worker
34826MNMDClinical Social Worker
0904018777VAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Sep 13, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

100 Cambridge St
Fl 14
Boston, MA 02114
Phone (617) 917-2389

2355 Highway 36 W
Ste 400
Saint Paul, MN 55113
Phone (612) 460-1597

8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598

Organizations & group practices 1

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": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1033950233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4371 TREVI CT",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334674082",
            "telephone_number": "772-446-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 SW REALTY ST",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872226",
            "telephone_number": "772-446-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "VALENCIA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW128199",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22994",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904018777",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "34826",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.