Individual provider Active NPI

Ashley Anna Superczynski

  • Clinical Social Worker
  • Pensacola, FL
National Provider Identifier
1053125112
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
ISW20626 Issued in FL
Practice address
1300 N Palafox St Ste 102
Pensacola, FL 32501-2678
Phone
(443) 694-7507
NPI assigned
Feb 6, 2025
Last updated
Feb 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 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 ISW20626 FL Primary

Addresses

Primary practice location

1300 N Palafox St Ste 102
Pensacola, FL 32501-2678

Mailing address

9688 Parker Lake Cir
Navarre, FL 32566-4801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ISW20626FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1053125112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9688 PARKER LAKE CIR",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325664801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N PALAFOX ST STE 102",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325012678",
            "telephone_number": "443-694-7507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPERCZYNSKI",
        "first_name": "ASHLEY",
        "middle_name": "ANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW20626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.