Wanda Esther Fuentes, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW21074 Issued in FL

Practice address

317 N Florida Ave
Deland, FL 32720-3483

Phone

(904) 701-8093

NPI assigned

Jun 22, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Solid Ground CounselingGroup PAC ID 8527445170, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Solid Ground Counseling

  • Community/Behavioral Health Agency
  • Deland, FL
  • NPI 1356081988
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1719014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719014400000",
    "number": "1053155226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 N FLORIDA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203483",
            "telephone_number": "904-701-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N FLORIDA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203483",
            "telephone_number": "904-701-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "WANDA",
        "middle_name": "ESTHER",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-22",
        "last_updated": "2024-06-22",
        "certification_date": "2024-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginamarie Francolino, LMHC
• Torey Freed
• Autumn Laine French, LMFT
• Jeffrey Friedman, D.O.
• Tracey Rae Fritzinger, RT(N), CNMT
• Full Circle Midwifery
• G. Barlow Enterprises
• Valerie Gaeta
• Debra Pardee Gaffney, AP
• Caylee Grace Gallagher, NP

• Clinical Social Worker in Deland, FL
• Providers in Deland, 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 Jun 22, 2024; 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.