Individual provider Active NPI

Dzhulyetta Moreno-Duffy, LCSW

  • Clinical Social Worker
  • Miami Shores, FL
National Provider Identifier
1104566546
Registry record updated Apr 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW19717 Issued in FL
Practice address
129 NW 98TH St
Miami Shores, FL 33150-1738
Phone
(305) 409-7967
NPI assigned
Apr 1, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2022

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 SW19717 FL Primary

Addresses

Primary practice location

129 NW 98TH St
Miami Shores, FL 33150-1738

Mailing address

129 NW 98TH St
Miami Shores, FL 33150-1738
Phone (305) 409-7967

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL duffywellness@gmail.com Direct

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW19717FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1648771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648771200000",
    "number": "1104566546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 NW 98TH ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331501738",
            "telephone_number": "305-409-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 NW 98TH ST",
            "city": "MIAMI SHORES",
            "state": "FL",
            "postal_code": "331501738",
            "telephone_number": "305-409-7967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO-DUFFY",
        "first_name": "DZHULYETTA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-01",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "duffywellness@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "129 NW 98th St",
            "city": "Miami Shores",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331501738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami Shores, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.