Individual provider Active NPI

Toni Marie Stephens, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1275761546
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9215 Issued in FL
Practice address
2400 Edgewood Ave N
Jacksonville, FL 32254-1727
Phone
(904) 781-0600
Fax
(904) 781-0016
NPI assigned
Jun 25, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X SW9215 FL Primary

Addresses

Primary practice location

2400 Edgewood Ave N
Jacksonville, FL 32254-1727

Mailing address

2400 Edgewood Ave N
Jacksonville, FL 32254-1727
Phone (904) 781-0600

Other practice location 1

3661 S Babcock St Ste 115
Melbourne, FL 32901-8205
Phone (321) 434-1660

Other identifiers 2

IdentifierTypeStateIssuer
029591400MedicaidFL
RI746OtherFLHFMG MA

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
I20230824001120 FL Practitioner - Clinical Social Worker 4981067931 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW9215FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Behavioral Health Services, Inc. Past Accepting new patients

Networks

  • Freedom Health HMO Network

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1275761546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 EDGEWOOD AVE N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541727",
            "telephone_number": "904-781-0600",
            "fax_number": "904-781-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 EDGEWOOD AVE N",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322541727",
            "telephone_number": "904-781-0600",
            "fax_number": "904-781-0016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3661 S Babcock St Ste 115",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329018205",
            "country_code": "US",
            "telephone_number": "321-434-1660",
            "fax_number": "321-725-1998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "TONI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029591400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HFMG MA",
            "identifier": "RI746",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.