Stephanie A Crofutt, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW14936 Issued in FL

Practice address

330 SW 27TH Ave
Fort Lauderdale, FL 33312-2051

Phone

(954) 463-0911

NPI assigned

Oct 22, 2020

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Aspire Health Partners, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Orlando, FL
  • NPI 1821033903
  Medicare reassignment
• Henderson Behavioral Health, Inc.

  • Family Medicine Physician
  • Lauderdale Lakes, FL
  • NPI 1154272706
  NPD (past)

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1164021937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N STATE ROAD 7",
            "city": "LAUDERDALE LAKES",
            "state": "FL",
            "postal_code": "333195839",
            "telephone_number": "954-486-4005",
            "fax_number": "954-497-3857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SW 27TH AVE",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333122051",
            "telephone_number": "954-463-0911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROFUTT",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elissa Crist, LMFT
• Jack Joseph Cristiano Jr., PA-C
• Tanese Croasdale
• Nikolas Crocker
• Crockett Foundation Inc
• Tabitha Crosno
• Brian J Cross, DO
• Peter W Cross, CRNA
• Crossroads Wellness Group, LLC
• Deadra E Crowel, RN

• Clinical Social Worker in Fort Lauderdale, FL
• Providers in Fort Lauderdale, 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 Oct 22, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.