Active NPI
Nicole Navega, LCSW
- Clinical Social Worker
- Fort Myers, FL
National Provider Identifier
1124267901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW15361
- Practice address
- 4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416 - Phone
- (239) 236-8784
- Fax
- (239) 790-2624
- NPI assigned
- Feb 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW15361 | FL | Primary |
| Counselor | 101Y00000X |
Addresses
Primary practice location
4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Mailing address
4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone (239) 236-8784
Other practice location 1
103 Bacon St
Pawtucket, RI 02860-5542
Phone (401) 722-3560
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GH57134 | Medicaid | RI |
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 |
|---|---|---|---|
| SW15361 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630454400000",
"number": "1124267901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4310 METRO PKWY STE 205",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339169416",
"telephone_number": "239-236-8784",
"fax_number": "239-790-2624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4310 METRO PKWY STE 205",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339169416",
"telephone_number": "239-236-8784",
"fax_number": "239-790-2624"
}
],
"practiceLocations": [
{
"address_1": "103 Bacon St",
"address_purpose": "LOCATION",
"city": "Pawtucket",
"state": "RI",
"postal_code": "028605542",
"country_code": "US",
"telephone_number": "401-722-3560",
"fax_number": "401-724-3120",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAVEGA",
"first_name": "NICOLE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-18",
"last_updated": "2021-09-01",
"certification_date": "2021-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW15361",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GH57134",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.