Individual provider Active NPI

Jessica R Mauger, LCSW

  • Clinical Social Worker
  • Maitland, FL
National Provider Identifier
1306447206
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13485 Issued in FL
Practice address
668 N Orlando Ave Ste 210
Maitland, FL 32751-4459
Phone
(407) 739-1794
NPI assigned
Nov 6, 2020
Last updated
Sep 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 13485 FL Primary

Addresses

Primary practice location

668 N Orlando Ave Ste 210
Maitland, FL 32751-4459

Mailing address

608 Webster Ave
Altamonte Springs, FL 32701-6315
Phone (407) 739-1794

Other practice location 1

1950 Lee Rd Ste 110
Winter Park, FL 32789-1847
Phone (407) 564-3459

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
I20220602001936 FL Practitioner - Clinical Social Worker 4981082948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Advance Bariatric CounselingGroup PAC ID 9739417254, 4 clinicians

Practice addresses (Care Compare)

1950 Lee Rd
Suite 110
Winter Park, FL 32789-1847
Phone (407) 564-3459

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13485FLMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Bariatric Counseling Clinical CurrentSince Apr 25, 2022 Accepting new patients

Locations

531 Versailles Dr
Ste 100
Maitland, FL 32751
Phone (407) 564-3459

1950 Lee Rd
Ste 110
Winter Park, FL 32789
Phone (407) 561-3459

Networks

  • Freedom Health HMO Network

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": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1306447206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 WEBSTER AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327016315",
            "telephone_number": "407-739-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 N ORLANDO AVE STE 210",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514459",
            "telephone_number": "407-739-1794"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 Lee Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327891847",
            "country_code": "US",
            "telephone_number": "407-564-3459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAUGER",
        "first_name": "JESSICA",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "13485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maitland, FL

Sources for this page

Verify at the official NPI Registry.