Individual provider Active NPI

Nancy J Stetter-Coblentz, LCSW

  • Clinical Social Worker
  • Venice, FL
National Provider Identifier
1093291833
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW15428 Issued in FL
Practice address
1790 E Venice Ave Ste 204
Venice, FL 34292-3191
Phone
(941) 488-8884
Fax
(941) 488-5554
NPI assigned
Jul 16, 2018
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 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 SW15428 FL Primary

Addresses

Primary practice location

1790 E Venice Ave Ste 204
Venice, FL 34292-3191

Mailing address

1790 E Venice Ave Ste 204
Venice, FL 34292-3191
Phone (941) 488-8884

Other names 1

  • Nancy J Stetter Former name

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
I20180830003627 FL Practitioner - Clinical Social Worker 4486904067 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cornerstone Psychiatric Services IncGroup PAC ID 8224113584, 5 clinicians

Practice addresses (Care Compare)

1790 E Venice Ave
Suite 204
Venice, FL 34292-3191
Phone (941) 488-8884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW15428FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Psychiatric Services Inc Clinical CurrentSince Jan 1, 2021 Accepting new patients

Locations

1790 E Venice Ave
Ste 204
Venice, FL 34292
Phone (941) 484-0766

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, 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": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1093291833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 E VENICE AVE STE 204",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342923191",
            "telephone_number": "941-488-8884",
            "fax_number": "941-488-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 E VENICE AVE STE 204",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342923191",
            "telephone_number": "941-488-8884",
            "fax_number": "941-488-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETTER-COBLENTZ",
        "first_name": "NANCY",
        "middle_name": "J",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-16",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NANCY",
            "last_name": "STETTER",
            "middle_name": "J",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.