Individual provider Active NPI

Odalys A Valencia, LCSW

  • Clinical Social Worker
  • Hialeah, FL
National Provider Identifier
1306989454
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 6436 Issued in FL
Practice address
5979 NW 151St St
Suite # 230
Hialeah, FL 33014-2400
Phone
(305) 362-1875
Fax
(305) 362-1920
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 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 SW 6436 FL Primary

Addresses

Primary practice location

5979 NW 151St St
Suite # 230
Hialeah, FL 33014-2400

Mailing address

5979 NW 151St St
Suite # 230
Hialeah, FL 33014-2400
Phone (305) 362-1875

Other identifiers 2

IdentifierTypeStateIssuer
000231400MedicaidFL
SW 6436OtherFLLCSW

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
I20031215000168 FL Practitioner - Clinical Social Worker 3375440803 Practice locations: Miami Lakes, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5979 NW 151 St
Suite 230
Miami Lakes, FL 33014-2467
Phone (305) 362-1875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 6436FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1306989454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5979 NW 151ST ST",
            "address_2": "SUITE # 230",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330142400",
            "telephone_number": "305-362-1875",
            "fax_number": "305-362-1920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 NW 151ST ST",
            "address_2": "SUITE # 230",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330142400",
            "telephone_number": "305-362-1875",
            "fax_number": "305-362-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "ODALYS",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 6436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000231400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "SW 6436",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hialeah, FL

Sources for this page

Verify at the official NPI Registry.