NPIMap

Organization Active NPI

Dominica J. Debrauwere LCSW, DCSW, Inc.

  • Clinical Social Worker
  • Marianna, FL
National Provider Identifier
1194080895
Registry record updated Jul 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3307 Issued in FL
Legal business name
DOMINICA J. DEBRAUWERE LCSW, DCSW, INC.
Practice address
4284 Kelson Ave.
Marianna, FL 32446-6399
Phone
(850) 443-9801
Fax
(850) 526-3349
NPI assigned
Jul 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2014

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

Authorized official

Name
Mrs. Dominica J. Debrauwere, MSW, LCSW, DCSW
Title
Therapist/President
Phone
(850) 443-9801

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X SW 3307 FL
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 3307 FL Primary

Addresses

Primary practice location

4284 Kelson Ave.
Marianna, FL 32446-6399

Mailing address

2584 Governors CT
Marianna, FL 32446-6399
Phone (850) 443-9801

Other identifiers 1

IdentifierTypeStateIssuer
1356423537OtherFLNPI

Other names 1

  • Dominica J. Parrott LCSW, DCSW, Inc. Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405641600000",
    "number": "1194080895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2584 GOVERNORS CT",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324466399",
            "telephone_number": "850-443-9801",
            "fax_number": "850-893-6013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4284 KELSON AVE.",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324466399",
            "telephone_number": "850-443-9801",
            "fax_number": "850-526-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINICA J. DEBRAUWERE LCSW, DCSW, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-09",
        "last_updated": "2014-07-18",
        "status": "A",
        "authorized_official_last_name": "DEBRAUWERE",
        "authorized_official_first_name": "DOMINICA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "THERAPIST/PRESIDENT",
        "authorized_official_telephone_number": "850-443-9801",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LCSW, DCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 3307",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "3307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1356423537",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dominica J. Parrott LCSW, DCSW, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Marianna, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.