Individual provider Active NPI

Richard Alfaro, LCSW

  • Clinical Social Worker
  • Melbourne, FL
National Provider Identifier
1285992826
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW2680 Issued in FL
Practice address
6767 N Wickham Rd
Suite 401
Melbourne, FL 32940-2031
Phone
(321) 421-6992
Fax
(321) 421-6993
NPI assigned
May 2, 2012
Last updated
May 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2012

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 SW2680 FL Primary

Addresses

Primary practice location

6767 N Wickham Rd
Suite 401
Melbourne, FL 32940-2031

Mailing address

6767 N Wickham Rd
Suite 401
Melbourne, FL 32940-2031
Phone (321) 421-6992

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
I20150120000921 FL Practitioner - Clinical Social Worker 0840514907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Counseling Services, LLCGroup PAC ID 0446415970, 5 clinicians

Practice addresses (Care Compare)

1301 W Eau Gallie Blvd
Suite 96
Melbourne, FL 32935-5390
Phone (321) 421-6992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW2680FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Counseling Services, LLC Clinical CurrentSince Jan 1, 2015 Accepting new patients

Locations

1301 W Eau Gallie Blvd
Ste 105
Melbourne, FL 32935
Phone 3214216992 ext. 105

1301 W Eau Gallie Blvd
Ste 96
Melbourne, FL 32935
Phone (321) 272-8336

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": "1335916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1285992826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 N WICKHAM RD",
            "address_2": "SUITE 401",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402031",
            "telephone_number": "321-421-6992",
            "fax_number": "321-421-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 N WICKHAM RD",
            "address_2": "SUITE 401",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402031",
            "telephone_number": "321-421-6992",
            "fax_number": "321-421-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALFARO",
        "first_name": "RICHARD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-02",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW2680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.