Individual provider Active NPI

Michael John Meehan, LCSW

  • Clinical Social Worker
  • St Augustine, FL
National Provider Identifier
1063496453
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW1047 Issued in FL
Practice address
9 Saint Johns Medical PK Dr
St Augustine, FL 32086-5343
Phone
(904) 797-2705
Fax
(904) 797-2820
NPI assigned
Nov 30, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 SW1047 FL Primary

Addresses

Primary practice location

9 Saint Johns Medical PK Dr
St Augustine, FL 32086-5343

Mailing address

9 Saint Johns Medical PK Dr
St Augustine, FL 32086-5343
Phone (904) 797-2705

Other identifiers 1

IdentifierTypeStateIssuer
Z1577OtherFLBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20101230000963 FL Practitioner - Clinical Social Worker 3274721550 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr. Townsend and Associates, P.a.Group PAC ID 4587852249, 6 clinicians

Practice addresses (Care Compare)

9 Saint Johns Medical Park Dr
Suite a
St Augustine, FL 32086-5955
Phone (904) 797-2705

9 St Johns Medical Park Dr
St a
St Augustine, FL 32086-5954

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW1047FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Townsend & Associates, P.a. CurrentSince Aug 16, 2010 Accepting new patients
Dr. Steven P. Dingfelder & Assoc., Inc. Past Accepting new patients

Locations

9 Saint Johns Medical Park Dr
St Augustine, FL 32086
Phone (904) 797-2705

9 Saint Johns Medical Park Dr
Ste A
St Augustine, FL 32086
Phone (904) 797-2705

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1063496453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SAINT JOHNS MEDICAL PK DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865343",
            "telephone_number": "904-797-2705",
            "fax_number": "904-797-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SAINT JOHNS MEDICAL PK DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865343",
            "telephone_number": "904-797-2705",
            "fax_number": "904-797-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEHAN",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW1047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "Z1577",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.