Individual provider Active NPI

Stephanie Lauren Sattar, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1265924799
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13223 Issued in FL
Practice address
4917 Ballygar Dr
Tallahassee, FL 32309-2435
Phone
(954) 309-5187
NPI assigned
May 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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 SW13223 FL Primary

Addresses

Primary practice location

4917 Ballygar Dr
Tallahassee, FL 32309-2435

Mailing address

4917 Ballygar Dr
Tallahassee, FL 32309-2435
Phone (954) 309-5187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, CO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180730002370 FL Practitioner - Clinical Social Worker 2062760697 Reassigns benefits to 4 organizations
I20241001003450 CO Practitioner - Clinical Social Worker 2062760697 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Extra Years Psychology California PCGroup PAC ID 3678075165, 4 clinicians

Practice addresses (Care Compare)

Tallahassee, FL 32309
Phone (206) 801-1621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Mar 3, 2025 Accepting new patients
Extra Years Psychology California PC CurrentSince Jul 18, 2025 Accepting new patients
Extrayears Psychology Texas PA CurrentSince Oct 11, 2025 Accepting new patients

Locations

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

333 SE 2nd Ave
Ste 2000
Miami, FL 33131
Phone (201) 581-3411

999 3rd Ave
Ste 3300
Seattle, WA 98104
Phone (206) 801-1621

1201 2nd Ave
Ste 900
Seattle, WA 98101
Phone (206) 801-1621

Organizations & group practices 5

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": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1265924799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4917 BALLYGAR DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092435",
            "telephone_number": "954-309-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4917 BALLYGAR DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323092435",
            "telephone_number": "954-309-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTAR",
        "first_name": "STEPHANIE",
        "middle_name": "LAUREN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.