Individual provider Active NPI

Debra Fegal, LCSW

  • Clinical Social Worker
  • Vero Beach, FL
National Provider Identifier
1093190746
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14106 Issued in FL
Practice address
1553 US Highway 1
Vero Beach, FL 32960-5735
Phone
(772) 257-8224
Fax
(772) 213-3157
NPI assigned
Jul 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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 SW14106 FL Primary

Addresses

Primary practice location

1553 US Highway 1
Vero Beach, FL 32960-5735

Mailing address

1545 9TH St SW
Vero Beach, FL 32962-4312
Phone (772) 257-8224

Other identifiers 1

IdentifierTypeStateIssuer
SW14106OtherFLSTATE LICENSE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14106FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1093190746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 9TH ST SW",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329624312",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1553 US HIGHWAY 1",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329605735",
            "telephone_number": "772-257-8224",
            "fax_number": "772-213-3157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEGAL",
        "first_name": "DEBRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "SW14106",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.