Individual provider Active NPI

Mindy Staum, LCSW

  • Clinical Social Worker
  • Coral Springs, FL
National Provider Identifier
1104139518
Registry record updated Aug 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9941 Issued in FL
Practice address
5421 N University Dr Ste 102
Coral Springs, FL 33067-4638
Phone
(954) 464-1393
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 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 SW9941 FL Primary

Addresses

Primary practice location

5421 N University Dr Ste 102
Coral Springs, FL 33067-4638

Mailing address

5421 N University Dr
Ste 102
Coral Springs, FL 33067-4638
Phone (954) 464-1393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, PA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120201000377 FL Practitioner - Clinical Social Worker 3678730777 Reassigns benefits to 1 organization
I20170210001389 PA Practitioner - Clinical Social Worker 3678730777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindy Staum LCSW PAGroup PAC ID 5890952998, 16 clinicians

Practice addresses (Care Compare)

5421 N University Dr
Suite 102
Coral Springs, FL 33067-4638
Phone (732) 580-8383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786147200000",
    "number": "1104139518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5421 N UNIVERSITY DR",
            "address_2": "STE 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674638",
            "telephone_number": "954-464-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5421 N UNIVERSITY DR STE 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330674638",
            "telephone_number": "954-464-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUM",
        "first_name": "MINDY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2026-08-08",
        "certification_date": "2026-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.