Individual provider Active NPI

Jaqueline Rose Vallina, LCSW

  • Clinical Social Worker
  • Ruskin, FL
National Provider Identifier
1225651540
Registry record updated Oct 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
MSW008678 Issued in GA
Practice address
10223 Count Fleet Dr
Ruskin, FL 33573-6774
Phone
(954) 793-5986
NPI assigned
May 20, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2025

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 MSW008678 GA Primary

Addresses

Primary practice location

10223 Count Fleet Dr
Ruskin, FL 33573-6774

Mailing address

10223 Count Fleet Dr
Ruskin, FL 33573-6774
Phone (954) 793-5986

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MSW008678GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761523200000",
    "number": "1225651540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10223 COUNT FLEET DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736774",
            "telephone_number": "954-793-5986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10223 COUNT FLEET DR",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335736774",
            "telephone_number": "954-793-5986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLINA",
        "first_name": "JAQUELINE",
        "middle_name": "ROSE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2025-10-27",
        "certification_date": "2025-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "MSW008678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ruskin, FL

Sources for this page

Verify at the official NPI Registry.