Individual provider Active NPI

Myriam M Zelada, LCSW

  • Clinical Social Worker
  • Fort Lauderdale, FL
National Provider Identifier
1053905828
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23266 Issued in FL
Practice address
3200 NE 36TH St Apt 1219
Fort Lauderdale, FL 33308-6766
Phone
(203) 548-9280
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 012673 CT
Clinical Social Worker 1041C0700X 23266 FL Primary

Addresses

Primary practice location

3200 NE 36TH St Apt 1219
Fort Lauderdale, FL 33308-6766

Mailing address

3200 NE 36TH St Apt 1219
Fort Lauderdale, FL 33308-6766
Phone (203) 548-9280

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
012673CTMDClinical Social Worker
23266FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Az Counseling and Consulting Clinical CurrentSince Jun 25, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1053905828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 NE 36TH ST APT 1219",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086766",
            "telephone_number": "203-548-9280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NE 36TH ST APT 1219",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333086766",
            "telephone_number": "203-548-9280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELADA",
        "first_name": "MYRIAM",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "012673",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "23266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; 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.