Individual provider Active NPI

Elizabeth M Adams, SOCIAL WORKER, CLINI

  • Clinical Social Worker
  • Venice, FL
National Provider Identifier
1104922335
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5089 Issued in FL
Practice address
492 Buttonbush Lane
Venice, FL 34293
Phone
(941) 441-5137
Fax
(305) 453-5144
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2012

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 SW5089 FL Primary

Addresses

Primary practice location

492 Buttonbush Lane
Venice, FL 34293

Mailing address

492 Buttonbush Lane
Venice, FL 34293
Phone (941) 441-5137

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW5089FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ultima Rehab-FL LLC CurrentSince Aug 26, 2019 Accepting new patients

Locations

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337126400000",
    "number": "1104922335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 BUTTONBUSH LANE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34293",
            "telephone_number": "941-441-5137",
            "fax_number": "305-453-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 BUTTONBUSH LANE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "34293",
            "telephone_number": "941-441-5137",
            "fax_number": "305-453-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "ELIZABETH",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "SOCIAL WORKER, CLINI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.