Individual provider Active NPI

Javon F Lucas, MSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1316283146
Registry record updated Dec 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09927230 Issued in CO
Practice address
13000 Bruce B Downs Blvd
Social Work Services Mail Stop 122
Tampa, FL 33612-4745
Phone
(813) 972-2000
NPI assigned
Dec 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2021

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 CSW.09927230 CO Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

13000 Bruce B Downs Blvd
Social Work Services Mail Stop 122
Tampa, FL 33612-4745

Mailing address

13000 Bruce B Downs Blvd
Social Work Service Mail Stop 122
Tampa, FL 33612-4745
Phone (813) 972-2000

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
I20210611000157 FL Practitioner - Clinical Social Worker 6002216124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Psychiatric Consulting Services, LLCGroup PAC ID 2466601943, 4 clinicians

Practice addresses (Care Compare)

10006 Cross Creek Blvd
Suite 518
Tampa, FL 33647-2595

9441 Health Ctr Dr
Land O Lakes, FL 34637-5837
Phone (813) 971-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09927230COMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Psychiatric Consulting Services, LLC CurrentSince Mar 10, 2021 Accepting new patients

Locations

9441 Health Center Dr
Land O Lakes, FL 34637
Phone (813) 903-3700

10006 Cross Creek Blvd
Tampa, FL 33647
Phone (813) 676-3636

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640649600000",
    "number": "1316283146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 BRUCE B DOWNS BLVD",
            "address_2": "SOCIAL WORK SERVICE MAIL STOP 122",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124745",
            "telephone_number": "813-972-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13000 BRUCE B DOWNS BLVD",
            "address_2": "SOCIAL WORK SERVICES MAIL STOP 122",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336124745",
            "telephone_number": "813-972-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JAVON",
        "middle_name": "F",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-26",
        "last_updated": "2021-12-28",
        "certification_date": "2021-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09927230",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.