Individual provider Active NPI

Celeiny Clark

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1083472005
Registry record updated Jan 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW22758 Issued in FL
Practice address
610 E Zack St Ste 110-2322
Tampa, FL 33602-3972
Phone
(813) 308-9339
Fax
(813) 563-0511
NPI assigned
Mar 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 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 SW22758 FL Primary

Addresses

Primary practice location

610 E Zack St Ste 110-2322
Tampa, FL 33602-3972

Mailing address

610 E Zack St Ste 110-2322
Tampa, FL 33602-3972
Phone (813) 308-9339

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
I20240514003640 FL Practitioner - Clinical Social Worker 1850732488 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Apr 3, 2024 Accepting new patients
Healing on Tampa CurrentSince May 11, 2025 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

610 E Zack St
Ste 1102322
Tampa, FL 33602
Phone (813) 308-9339

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769212800000",
    "number": "1083472005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 E ZACK ST STE 110-2322",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023972",
            "telephone_number": "813-308-9339",
            "fax_number": "813-563-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 E ZACK ST STE 110-2322",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336023972",
            "telephone_number": "813-308-9339",
            "fax_number": "813-563-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CELEINY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-13",
        "last_updated": "2026-01-24",
        "certification_date": "2026-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.