Individual provider Active NPI

L Daisy Skinner, MSW

  • Clinical Social Worker
  • Wellington, FL
National Provider Identifier
1275602823
Registry record updated Aug 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 6240 Issued in FL
Practice address
12777 W Forest Hill Blvd
Suite 1501
Wellington, FL 33414-4775
Phone
(561) 795-9079
Fax
(561) 795-9033
NPI assigned
Nov 7, 2006
Last updated
Aug 24, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2010

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 SW 6240 FL Primary

Addresses

Primary practice location

12777 W Forest Hill Blvd
Suite 1501
Wellington, FL 33414-4775

Mailing address

12777 W Forest Hill Blvd
Suite 1501
Wellington, FL 33414-4775
Phone (561) 795-9079

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
I20070822000288 FL Practitioner - Clinical Social Worker 5799877825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

14199 Orange Blvd
Loxahatchee, FL 33470-4511
Phone (561) 795-9079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 6240FLMDClinical Social Worker

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282608000000",
    "number": "1275602823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12777 W FOREST HILL BLVD",
            "address_2": "SUITE 1501",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144775",
            "telephone_number": "561-795-9079",
            "fax_number": "561-795-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12777 W FOREST HILL BLVD",
            "address_2": "SUITE 1501",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334144775",
            "telephone_number": "561-795-9079",
            "fax_number": "561-795-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "L",
        "middle_name": "DAISY",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2010-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 6240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.