Alyssa A Thaxton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW14679 Issued in FL

Practice address

1100 Plantation Island Dr S Ste 110-120
St Augustine, FL 32080-5173

Phone

(904) 824-7733

NPI assigned

Sep 21, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, FL, KS, NC, CA5 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 5

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Optum Behavioral Care of North Carolina PCGroup PAC ID 5092120030, 175 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts, Master of Arts

State licenses

Practice roles

Locations

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.

• Optum Behavioral Care of North Carolina, PC

  • Counseling Psychologist
  • Sarasota, FL
  • NPI 1033984448
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical, GA, NC

  Medicare reassignment NPD
• Grow Healthcare Group of Kansas PA

  • Mental Health Counselor
  • Wichita, KS
  • NPI 1831848316

  Clinical

  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • St Petersburg, FL
  • NPI 1295629756
  NPD
• Optum Behavioral Care of North Carolina, P.C.

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1861371718
  NPD

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754006400000",
    "number": "1043544356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 PLANTATION ISLAND DR S STE 110-120",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320805173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 PLANTATION ISLAND DR S STE 110-120",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320805173",
            "telephone_number": "904-824-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAXTON",
        "first_name": "ALYSSA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-21",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CWS004742",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9980-C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tender Care Medical Services of St. Johns County, Inc.
• Tender Loving Care Health Care Services of Florida, L.L.C. (Amedisys Home Health)
• Tender Luvin Care III Corp
• Deborah Fisher Terry, DNP, ARNP, ANP-BC
• Kimberly Dawn Terry, PHARM D
• The Arc of the St Johns
• The Arc of the St Johns, Inc.
• The Arc of the St. Johns
• The Arc of the St. Johns, Inc.
• The Best Dentist in Saint Augustine PLLC

• Clinical Social Worker in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.