Individual provider Active NPI

Molly Sanford, LCSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1245357029
Registry record updated Sep 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW5734 Issued in FL
Practice address
1 Crisis Center PLZ
Tampa, FL 33613-1238
Phone
(813) 264-9955
Fax
(813) 969-4950
NPI assigned
Mar 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2017

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 SW5734 FL Primary

Addresses

Primary practice location

1 Crisis Center PLZ
Tampa, FL 33613-1238

Mailing address

4929 Van Dyke Rd
Lutz, FL 33558-4813
Phone (813) 841-4762

Other identifiers 2

IdentifierTypeStateIssuer
088345003MedicaidFL
1013902956OtherFLNPI GROUP NUMBER

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
I20110621000545 FL Practitioner - Clinical Social Worker 6709064777 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4913 Van Dyke Rd
Lutz, FL 33558-4813
Phone (813) 841-4762

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Center for Rapid Resolution Therapy LLC CurrentSince Feb 5, 2011 Accepting new patients
The Crisis Center of Tampa Bay Inc Past Accepting new patients
Crisis Center of Tampa Bay Past Accepting new patients
Premier Internal Medicine of Tampa LLC Past Accepting new patients

Locations

4913 Van Dyke Rd
Lutz, FL 33558
Phone (813) 841-4762

4929 Van Dyke Rd
Lutz, FL 33558
Phone (813) 269-0020

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1245357029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4929 VAN DYKE RD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335584813",
            "telephone_number": "813-841-4762",
            "fax_number": "813-961-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CRISIS CENTER PLZ",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131238",
            "telephone_number": "813-264-9955",
            "fax_number": "813-969-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "MOLLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-25",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088345003",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP NUMBER",
            "identifier": "1013902956",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.