Active NPI
Beverley N Mucciardi, LCSW
- Clinical Social Worker
- Coral Springs, FL
National Provider Identifier
1124077896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW5218
- Practice address
- 10100 W Sample Rd
Suite 332
Coral Springs, FL 33065-3973 - Phone
- (954) 825-0020
- Fax
- (954) 825-0044
- NPI assigned
- May 9, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW5218 | FL | Primary |
Addresses
Primary practice location
10100 W Sample Rd
Suite 332
Coral Springs, FL 33065-3973
Mailing address
10100 W Sample Rd
Suite 332
Coral Springs, FL 33065-3973
Phone (954) 825-0020
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW5218 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mindpath Health Florida, PLLC | Clinical | Past | Accepting new patients |
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": "1147132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208217600000",
"number": "1124077896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10100 W SAMPLE RD",
"address_2": "SUITE 332",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330653973",
"telephone_number": "954-825-0020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10100 W SAMPLE RD",
"address_2": "SUITE 332",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330653973",
"telephone_number": "954-825-0020",
"fax_number": "954-825-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUCCIARDI",
"first_name": "BEVERLEY",
"middle_name": "N",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-09",
"last_updated": "2008-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW5218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.