Individual provider Active NPI

Niesia Deshae Garza, LCSW

  • Clinical Social Worker
  • Navarre, FL
National Provider Identifier
1275083313
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13701 Issued in FL
Practice address
1754 Sea Lark LN
Navarre, FL 32566-7406
Phone
(850) 780-3496
Fax
(850) 462-2094
NPI assigned
Oct 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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 SW13701 FL Primary

Addresses

Primary practice location

1754 Sea Lark LN
Navarre, FL 32566-7406

Mailing address

1754 Sea Lark LN
Navarre, FL 32566-7406
Phone (850) 780-3496

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
I20170410000752 FL Practitioner - Clinical Social Worker 0840576609 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Daniels Harbor Therapy Center LLCGroup PAC ID 9032446067, 2 clinicians

Practice addresses (Care Compare)

1754 Sea Lark LN
Navarre, FL 32566-7406
Phone (850) 780-3496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Daniels Harbor Therapy Center LLC Clinical CurrentSince Jul 1, 2019 Accepting new patients

Locations

1754 Sea Lark Ln
Navarre, FL 32566
Phone (850) 780-3496

1760 Sea Lark Ln
Navarre, FL 32566

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581033600000",
    "number": "1275083313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1754 SEA LARK LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667406",
            "telephone_number": "850-780-3496",
            "fax_number": "850-462-2094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1754 SEA LARK LN",
            "city": "NAVARRE",
            "state": "FL",
            "postal_code": "325667406",
            "telephone_number": "850-780-3496",
            "fax_number": "850-462-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARZA",
        "first_name": "NIESIA",
        "middle_name": "DESHAE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-13",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Navarre, FL

Sources for this page

Verify at the official NPI Registry.