Etta F. Ettlinger, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW6310 Issued in FL

Practice address

100 Executive Way
Suite #110
Ponte Vedra, FL 32082-4753

Phone

(904) 273-4099

Fax

(904) 273-4095

NPI assigned

Dec 27, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Etta Ettlinger, LCSW, PA

  • Clinical Social Worker
  • Ponte Vedra, FL
  • NPI 1932384351
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1144207713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE WAY",
            "address_2": "SUITE #110",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320824753",
            "telephone_number": "904-273-4099",
            "fax_number": "904-273-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EXECUTIVE WAY",
            "address_2": "SUITE #110",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320824753",
            "telephone_number": "904-273-4099",
            "fax_number": "904-273-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTLINGER",
        "first_name": "ETTA",
        "middle_name": "F.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "LCSW6310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Endodontics 2 PLLC
• Zachary Engel, DPT
• David Engelman, MA
• Caterina Therese Eppolito
• Etta Ettlinger, LCSW, PA
• David Falden, OD
• Mark David Fay, P.T.
• Femmewell Holdings LLC (Femmewell)
• Naara Ferguson, RN
• Michael Filipkowski

• Clinical Social Worker in Ponte Vedra, FL
• Providers in Ponte Vedra, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.