Individual provider Active NPI

Melissa Anne Wijngaarde

  • Clinical Social Worker
  • West Palm Beach, FL
National Provider Identifier
1245477892
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9149 Issued in FL
Practice address
3333 Forest Hill Blvd FL 2
West Palm Beach, FL 33406-5812
Phone
(954) 818-5827
NPI assigned
Jan 18, 2009
Last updated
Sep 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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 SW9149 FL
Clinical Social Worker 1041C0700X SW9149 FL Primary

Addresses

Primary practice location

3333 Forest Hill Blvd FL 2
West Palm Beach, FL 33406-5812

Mailing address

3333 Forest Hill Blvd FL 2
West Palm Beach, FL 33406-5812
Phone (954) 818-5827

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Case Management Organization, Inc PastSince Sep 20, 2022 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": "1232236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1245477892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 FOREST HILL BLVD FL 2",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065812",
            "telephone_number": "954-818-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 FOREST HILL BLVD FL 2",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334065812",
            "telephone_number": "954-818-5827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIJNGAARDE",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-18",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW9149",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; 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.