Individual provider Active NPI

Mary E Lopusnak, LCSW

  • Clinical Social Worker
  • Wesley Chapel, FL
National Provider Identifier
1063700649
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10283 Issued in FL
Practice address
2240 Twelve Oaks Way Ste 102
Wesley Chapel, FL 33544-6970
Phone
(813) 713-9402
Fax
(888) 428-5910
NPI assigned
Jul 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 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 SW10283 FL Primary

Addresses

Primary practice location

2240 Twelve Oaks Way Ste 102
Wesley Chapel, FL 33544-6970

Mailing address

4415C Constitution LN # 118
Marianna, FL 32448-4472
Phone (813) 713-9402

Other practice location 1

4415C Constitution Ln # 118
Marianna, FL 32448-4472
Phone (813) 713-9402 ext. 700

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
I20150623001432 FL Practitioner - Clinical Social Worker 9739490368 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2240 Twelve Oaks Way
Suite 102
Wesley Chapel, FL 33544-6970
Phone 8137139402700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nouveau Hope Counseling, LLC CurrentSince Jul 25, 2019 Accepting new patients
Florida Medical Clinic, LLC CurrentSince Jun 1, 2015 Accepting new patients
Florida Medical Clinic LLC CurrentSince Jun 1, 2015 Accepting new patients
Divine Minds Wellness CurrentSince Jun 15, 2021 Accepting new patients
His Storehouse Outreach, Inc. Clinical Past Accepting new patients

Locations

4415C Constitution Ln
Marianna, FL 32448
Phone 8137139402 ext. 700

2240 Twelve Oaks Way
Ste 102
Wesley Chapel, FL 33544
Phone (813) 713-9402

2241 Green Hedges Way
Ste 102
Wesley Chapel, FL 33544
Phone (813) 973-1304

38135 Market Square Dr
Zephyrhills, FL 33542
Phone (352) 567-0188

Organizations & group practices 5

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": "1310688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1063700649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415C CONSTITUTION LN # 118",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324484472",
            "telephone_number": "813-713-9402",
            "fax_number": "888-428-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 TWELVE OAKS WAY STE 102",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335446970",
            "telephone_number": "813-713-9402",
            "fax_number": "888-428-5910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4415C Constitution Ln # 118",
            "address_purpose": "LOCATION",
            "city": "Marianna",
            "state": "FL",
            "postal_code": "324484472",
            "country_code": "US",
            "telephone_number": "813-713-9402 x700",
            "fax_number": "888-428-5910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOPUSNAK",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-15",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

Verify at the official NPI Registry.