Organization Active NPI

Jessica Anne Deeb, LCSW, LLC

  • Clinical Social Worker
  • New Port Richey, FL
National Provider Identifier
1104178607
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 8591 Issued in FL
Legal business name
JESSICA ANNE DEEB, LCSW, LLC
Practice address
9400 River Crossing Blvd
Suite 101
New Port Richey, FL 34655-6033
Phone
(727) 808-4818
NPI assigned
Oct 8, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Jessica Anne Deeb, LCSWNPI 1114240777
Title
Owner
Phone
(727) 808-4818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X SW 8591 FL Primary

Addresses

Primary practice location

9400 River Crossing Blvd
Suite 101
New Port Richey, FL 34655-6033

Mailing address

9400 River Crossing Blvd
Suite 101
New Port Richey, FL 34655-6033
Phone (727) 808-4818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121107000139 FL Part B Supplier - Clinic/Group Practice 6709037476 Receives reassigned benefits from 1 practitioner
Practice locations: New Port Richey, FL; Tampa, FL

National Provider Directory

National Provider Directory
Tax ID family
Jessica Anne Deeb LCSW LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9400 River Crossing Blvd
Ste 101
New Port Richey, FL 34655
Phone (727) 203-6713

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1349654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1104178607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 RIVER CROSSING BLVD",
            "address_2": "SUITE 101",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346556033",
            "telephone_number": "727-808-4818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 RIVER CROSSING BLVD",
            "address_2": "SUITE 101",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346556033",
            "telephone_number": "727-808-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA ANNE DEEB, LCSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-08",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "DEEB",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-808-4818",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 8591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.