Individual provider Active NPI

Cozette Drake, LCSW

  • Clinical Social Worker
  • Fort Walton Beach, FL
National Provider Identifier
1144646001
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11856 Issued in FL
Practice address
137 Hospital Dr NE
Fort Walton Beach, FL 32548-5063
Phone
(850) 833-7451
Fax
(850) 833-7439
NPI assigned
Mar 14, 2014
Last updated
Mar 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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 SW11856 FL Primary

Addresses

Primary practice location

137 Hospital Dr NE
Fort Walton Beach, FL 32548-5063

Mailing address

137 Hospital Dr NE
Fort Walton Beach, FL 32548-5063
Phone (850) 833-7451

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

NPI Registry JSON

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

{
    "created_epoch": "1394755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1144646001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 HOSPITAL DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485063",
            "telephone_number": "850-833-7451",
            "fax_number": "850-833-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 HOSPITAL DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485063",
            "telephone_number": "850-833-7451",
            "fax_number": "850-833-7439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAKE",
        "first_name": "COZETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-14",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.