Individual provider Active NPI

Robert Jack Bedworth, LCSW

  • Clinical Social Worker
  • Melbourne, FL
National Provider Identifier
1265589279
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7727 Issued in FL
Practice address
3040 N Wickham Rd
Suite 10
Melbourne, FL 32935-2369
Phone
(321) 751-7000
Fax
(321) 751-7055
NPI assigned
Jan 4, 2007
Last updated
Jan 29, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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 SW7727 FL Primary
Clinical Social Worker 1041C0700X C019310 NC

Addresses

Primary practice location

3040 N Wickham Rd
Suite 10
Melbourne, FL 32935-2369

Mailing address

3040 N Wickham Rd
Suite 10
Melbourne, FL 32935-2369
Phone (321) 751-7000

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
I20260204001799 FL Practitioner - Clinical Social Worker 3072092667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2261 Market St
San Francisco, CA 94114-1612

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW7727FLMDClinical Social Worker
C019310NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Health, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Freedom Counseling Ministries Inc. Past Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

6501 Arlington Expy
Ste B105
Jacksonville, FL 32211
Phone (904) 302-9355

Organizations & group practices 2

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": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1265589279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 N WICKHAM RD",
            "address_2": "SUITE 10",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352369",
            "telephone_number": "321-751-7000",
            "fax_number": "321-751-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 N WICKHAM RD",
            "address_2": "SUITE 10",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352369",
            "telephone_number": "321-751-7000",
            "fax_number": "321-751-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDWORTH",
        "first_name": "ROBERT",
        "middle_name": "JACK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7727",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C019310",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.