Individual provider Active NPI

Elcie Ardain, LCSW

  • Clinical Social Worker
  • Lake Worth, FL
National Provider Identifier
1104083773
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 8983 Issued in FL
Practice address
8387 Myakka CT
Lake Worth, FL 33467-6228
Phone
(561) 252-3787
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2008

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 SW 8983 FL Primary

Addresses

Primary practice location

8387 Myakka CT
Lake Worth, FL 33467-6228

Mailing address

8387 Myakka CT
Lake Worth, FL 33467-6228
Phone (561) 252-3787

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
I20140421001242 FL Practitioner - Clinical Social Worker 9234361502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1615 S Congress Ave
Delray Beach, FL 33445-6326
Phone (561) 252-3787

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 8983FLMDClinical Social Worker

Practice roles (2 of 3)

OrganizationSpecialtyStatusNew patients
His Therapeutic Counseling Center LLC CurrentSince Jan 19, 2014 Accepting new patients
Supportive Healing Center Inc. Clinical Past Accepting new patients

Locations

1615 S Congress Ave
Ste 103
Delray Beach, FL 33445
Phone (561) 602-4114

6801 Lake Worth Rd
Ste 202
Greenacres, FL 33467
Phone (561) 249-7335

Networks

  • Freedom Health HMO Network

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1104083773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8387 MYAKKA CT",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676228",
            "telephone_number": "561-252-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8387 MYAKKA CT",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334676228",
            "telephone_number": "561-252-3787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDAIN",
        "first_name": "ELCIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 8983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Worth, FL

Sources for this page

Verify at the official NPI Registry.