Individual provider Active NPI

Cynthia Portalatin, LCSW

  • Clinical Social Worker
  • St Thomas, VI
National Provider Identifier
1053094169
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1-29632-1B Issued in VI
Practice address
9048 Sugar Est
St Thomas, VI 00802-3634
Phone
(340) 776-8311
NPI assigned
Aug 8, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 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 1-29632-1B VI Primary

Addresses

Primary practice location

9048 Sugar Est
St Thomas, VI 00802-3634

Mailing address

9048 Sugar Est
St Thomas, VI 00802-3634
Phone (340) 776-8311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
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
I20230906001882 VI Practitioner - Clinical Social Worker 5395108583 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Lindsy Wagner LLCGroup PAC ID 3476800574, 16 clinicians

Practice addresses (Care Compare)

5330 J Yacht Haven Grande
Suite 201 and 205
St Thomas, VI 00802-5000
Phone (340) 719-7007

9048 Sugar Est
St Thomas, VI 00802-3634
Phone (340) 776-8311

9048 Sugar Estate
St Thomas, VI 00802-3634

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-29632-1BVIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
VI Government Hospital and Health Facilities Corp Current Accepting new patients

Locations

9048 Sugar Est
St Thomas, VI 00802
Phone (340) 693-6211

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1053094169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9048 SUGAR EST",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008023634",
            "telephone_number": "340-776-8311",
            "fax_number": "340-693-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9048 SUGAR EST",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008023634",
            "telephone_number": "340-776-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTALATIN",
        "first_name": "CYNTHIA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-08",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VI",
            "license": "1-29632-1B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Thomas, VI

Sources for this page

Verify at the official NPI Registry.