Individual provider Active NPI

Laura Michelle Delaney, LCSW-C

  • Clinical Social Worker
  • Riverview, FL
National Provider Identifier
1245440866
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14615 Issued in FL
Practice address
11525 Sunburst Marble Rd
Riverview, FL 33579-2119
Phone
(813) 252-0978
Fax
(813) 756-2832
NPI assigned
May 23, 2007
Last updated
Jul 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12856 MD
Clinical Social Worker 1041C0700X SW14615 FL Primary

Addresses

Primary practice location

11525 Sunburst Marble Rd
Riverview, FL 33579-2119

Mailing address

11525 Sunburst Marble Rd
Riverview, FL 33579-2119
Phone (813) 252-0978

Other names 1

  • Laura Michelle Wilmoth Former name

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
I20231002001401 FL Practitioner - Clinical Social Worker 8426197799 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11525 Sunburst Marble Rd
Riverview, FL 33579-2119
Phone (813) 252-0978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12856MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Adaska Therapy and Wellness LLC Clinical CurrentSince Jun 1, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1245440866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11525 SUNBURST MARBLE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335792119",
            "telephone_number": "813-252-0978",
            "fax_number": "813-756-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11525 SUNBURST MARBLE RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335792119",
            "telephone_number": "813-252-0978",
            "fax_number": "813-756-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELANEY",
        "first_name": "LAURA",
        "middle_name": "MICHELLE",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12856",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "WILMOTH",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Riverview, FL

Sources for this page

Verify at the official NPI Registry.