Individual provider Active NPI

Mary Elizabeth Winn, LCSW

  • Clinical Social Worker
  • Wellington, FL
National Provider Identifier
1114289493
Registry record updated Oct 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10583 Issued in FL
Practice address
12161 Ken Adams Way
Ste 179
Wellington, FL 33414-3191
Phone
(561) 598-8585
Fax
(561) 227-1510
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2018

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 SW10583 FL Primary

Addresses

Primary practice location

12161 Ken Adams Way
Ste 179
Wellington, FL 33414-3191

Mailing address

2395 Sapphire Cir
West Palm Beach, FL 33411-5199
Phone (561) 714-5889

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
I20130409000453 FL Practitioner - Clinical Social Worker 6103062534 Practice locations: Winter Haven, FL

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

Practice addresses (Care Compare)

5212 Pebble Beach Blvd
Winter Haven, FL 33884-3539
Phone (561) 234-6778

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540166400000",
    "number": "1114289493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 SAPPHIRE CIR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334115199",
            "telephone_number": "561-714-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12161 KEN ADAMS WAY",
            "address_2": "STE 179",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143191",
            "telephone_number": "561-598-8585",
            "fax_number": "561-227-1510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINN",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2018-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.