Individual provider Active NPI

Devina D Cruickshank, LCSW

  • Clinical Social Worker
  • Hollywood, FL
National Provider Identifier
1275766933
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9573 Issued in FL
Practice address
3858 Sheridan St
Hollywood, FL 33021-3625
Phone
(954) 832-3602
Fax
(954) 272-7525
NPI assigned
Aug 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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 RCSW8316 ZZ
Clinical Social Worker 1041C0700X SW9573 FL Primary

Addresses

Primary practice location

3858 Sheridan St
Hollywood, FL 33021-3625

Mailing address

3858 Sheridan St
Hollywood, FL 33021-3625
Phone (954) 832-3602

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
I20111114000651 FL Practitioner - Clinical Social Worker 7214100882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4700 Sheridan St
Hollywood, FL 33021-3416
Phone (954) 832-3602

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RCSW8316ZZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DCB Coaching LLC Clinical Current 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": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1275766933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3858 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213625",
            "telephone_number": "954-832-3602",
            "fax_number": "954-272-7525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3858 SHERIDAN ST",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330213625",
            "telephone_number": "954-832-3602",
            "fax_number": "954-272-7525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUICKSHANK",
        "first_name": "DEVINA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ZZ",
            "license": "RCSW8316",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.