Individual provider Active NPI

Lynn Odinov-Daniels, LCSW; NCPSYA

  • Mental Health Counselor
  • Wellington, FL
National Provider Identifier
1164448312
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LCSW:6942 Issued in FL
Practice address
10492 Galleria St
Wellington, FL 33414-3160
Phone
(561) 422-1145
Fax
(561) 422-3198
NPI assigned
Jul 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LCSW:6942 FL Primary
Mental Health Counselor 101YM0800X LCSW:R044008 NY

Addresses

Primary practice location

10492 Galleria St
Wellington, FL 33414-3160

Mailing address

10492 Galleria St
Wellington, FL 33414-3160
Phone (561) 422-1145

Other identifiers 4

IdentifierTypeStateIssuer
P911096OtherNYNCPSYA
SW6942OtherFLLCSW
R044008OtherNYLCSW
11348023OtherFLCAQH

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20040818000220 FL Practitioner - Clinical Social Worker 4082697362 Practice locations: Wellington, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

10492 Galleria St
Wellington, FL 33414-3160
Phone (561) 422-1145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW:6942FLMDMental Health Counselor
LCSW:R044008NYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164448312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10492 GALLERIA ST",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143160",
            "telephone_number": "561-422-1145",
            "fax_number": "561-422-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10492 GALLERIA ST",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143160",
            "telephone_number": "561-422-1145",
            "fax_number": "561-422-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODINOV-DANIELS",
        "first_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LCSW; NCPSYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "LCSW:6942",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "LCSW:R044008",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPSYA",
            "identifier": "P911096",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "SW6942",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "R044008",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11348023",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.