John T Phipps, LCSW
Individual provider Active NPI Clinical Social Worker · Interlachen, FL
NPI 1124116090 · NPPES record last updated May 29, 2008
Key facts
- NPI
- 1124116090
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- SW8410 (FL)
- Practice address
- 1213 State Road 20
Interlachen, FL 32148-2737 - Phone
- (386) 684-4914
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| T Med Behavioral Inc | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW8410 | FL | Yes |
Addresses
Primary practice location
1213 State Road 20
Interlachen, FL 32148-2737
Mailing address
1302 River St
Palatka, FL 32177-5042
Phone (386) 328-0108
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Z125B | Other | FL | BLUE CROSS BLUE SHIELD |
Other providers in Interlachen, FL
- Javier Jose Martiney
- Ralph Michael McMenemy
- Melisa T Crosby, PT P.a.
- Metro Pharmaceutical Services Inc
- Veronica Milton
- Natalie L Romero-Newcomer
- Rural Health Care Incorporated
- Rural Health Care, Inc.
- Joanne Sheptock
- Lisa Anne St Pierre
All providers in Interlachen, FL · Clinical Social Worker in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.