Individual provider Active NPI

Terra Ladaun Prince-Engram, LCSW, CAP, ICADC

  • Clinical Social Worker
  • Miami, FL
National Provider Identifier
1235553256
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11999 Issued in FL
Practice address
1492 W Flagler St
Miami, FL 33135-2209
Phone
(786) 365-6659
NPI assigned
Feb 11, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X SW11999 FL Primary

Addresses

Primary practice location

1492 W Flagler St
Miami, FL 33135-2209

Mailing address

1492 W Flagler St
Miami, FL 33135-2209
Phone (786) 365-6659

Other names 1

  • Terra Ladaun Prince Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW11999FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1235553256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1492 W FLAGLER ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352209",
            "telephone_number": "786-365-6659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1492 W FLAGLER ST",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352209",
            "telephone_number": "786-365-6659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRINCE-ENGRAM",
        "first_name": "TERRA",
        "middle_name": "LADAUN",
        "credential": "LCSW, CAP, ICADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-11",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRA",
            "last_name": "PRINCE",
            "middle_name": "LADAUN",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.