Dedra McIntosh

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW25455 Issued in FL

Practice address

2833 NW 91St Ave Apt 104
Coral Springs, FL 33065-5066

Phone

(954) 955-6145

NPI assigned

Aug 21, 2025

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

Specialty

Clinical Social Worker

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Senior Living Memory Health IncGroup PAC ID 7517480577, 113 clinicians

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 and National Provider Directory roles.

• Senior Living Memory Health, Inc.

  • Clinical Psychologist
  • North Miami Beach, FL
  • NPI 1851847834
  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1174401830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2833 NW 91ST AVE APT 104",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655066",
            "telephone_number": "954-955-6145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2833 NW 91ST AVE APT 104",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655066",
            "telephone_number": "954-955-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "DEDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW25455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marsh McEachrane, M.D.
• Nastassia Rosanne McFadden
• Ashley Rae McFarlane, LCSW
• Kaitlyn McGowan
• Margaret Storm McGuiness, AUD
• Brittany McKenna
• Ashley McKenzie, DC
• Carol Ann McKenzie, M.D.
• Natallia Nastassia McKenzie, NP
• Dominique Milan McKoy

• Clinical Social Worker in Coral Springs, FL
• Providers in Coral Springs, 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 Sep 22, 2025; 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.