Individual provider Active NPI

Gisella Ubillus, LCSW

  • Clinical Social Worker
  • Winter Park, FL
National Provider Identifier
1306173919
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12793 Issued in FL
Practice address
315 N Lakemont Ave Ste B
Winter Park, FL 32792-3205
Phone
(407) 830-6412
NPI assigned
Nov 3, 2009
Last updated
Jan 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X SW12793 FL Primary

Addresses

Primary practice location

315 N Lakemont Ave Ste B
Winter Park, FL 32792-3205

Mailing address

PO Box 781153
Orlando, FL 32878-1153
Phone (407) 406-1347

Other identifiers 1

IdentifierTypeStateIssuer
GIZ0923MedicaidFL

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
I20170403000737 FL Practitioner - Clinical Social Worker 8325323496 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW12793FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
People Expressing and Caring for Their Emotions, LLC Clinical CurrentSince Feb 1, 2017 Accepting new patients
MCR Health, Inc. CurrentSince Mar 1, 2017 Accepting new patients
MCR Health, Inc. CurrentSince Mar 1, 2017 Accepting new patients

Locations

1802 N Alafaya Trl
Orlando, FL 32826
Phone (407) 406-1347

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1257206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1306173919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781153",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328781153",
            "telephone_number": "407-406-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N LAKEMONT AVE STE B",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923205",
            "telephone_number": "407-830-6412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UBILLUS",
        "first_name": "GISELLA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-03",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GIZ0923",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.