Mildred W Phillips, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW1370 Issued in FL

Practice address

4903 Van Dyke Road
Lutz, FL 33558-4813

Phone

(813) 265-3859

Fax

(813) 265-3966

NPI assigned

Aug 29, 2006

Last updated

Nov 17, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Center of Agape Christian Counseling, LLC

  • Clinical Social Worker
  • Lutz, FL
  • NPI 1184091183
  Medicare reassignment Authorized official
• Life Connections Counseling Center of Florida, Inc.

  • Voluntary or Charitable Agency
  • Lutz, FL
  • NPI 1770623035
  NPD (past)

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1053429852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4903 VAN DYKE ROAD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-265-3859",
            "fax_number": "813-265-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4903 VAN DYKE ROAD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-265-3859",
            "fax_number": "813-265-3966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MILDRED",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW1370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Peters, CAA
• Matthew Peterson, CRPS
• Ashley Petrow
• Pharmxpress LLC (Pharmxpress Pharmacy)
• Rantz Phelps, LMHC
• Phoebe Maisto Counseling Services LLC
• Physicial Medicine & Rehab Consultants (RegenMed of Florida)
• Physician's Walk in Clinic
• Physiohealth and Rehab, Inc.
• Physiotherapy Associates Inc

• Clinical Social Worker in Lutz, FL
• Providers in Lutz, 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 Nov 17, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.