Individual provider Active NPI

Annette Acosta, LCSW

  • Clinical Social Worker
  • Ft Lauderdale, FL
National Provider Identifier
1154936359
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14064 Issued in FL
Practice address
3800 W Broward Blvd
Ft Lauderdale, FL 33312-1018
Phone
(954) 587-1008
NPI assigned
Sep 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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 SW14064 FL Primary

Addresses

Primary practice location

3800 W Broward Blvd
Ft Lauderdale, FL 33312-1018

Mailing address

1211 Scioto Rd
North Lauderdale, FL 33068-3956
Phone (954) 553-2387

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW14064FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1154936359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 SCIOTO RD",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "330683956",
            "telephone_number": "954-553-2387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W BROWARD BLVD",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333121018",
            "telephone_number": "954-587-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACOSTA",
        "first_name": "ANNETTE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.