Individual provider Active NPI

Kristen Midgette, LCSW

  • Social Worker
  • Hollywood, FL
National Provider Identifier
1326523747
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
6067 Hollywood Blvd Ste 200
Hollywood, FL 33024-7922
Phone
(786) 414-6666
NPI assigned
Oct 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

6067 Hollywood Blvd Ste 200
Hollywood, FL 33024-7922

Mailing address

6067 Hollywood Blvd Ste 200
Hollywood, FL 33024-7922
Phone (516) 567-3038

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
I20210505001650 FL Practitioner - Clinical Social Worker 9931518826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Senior Living Memory Health IncGroup PAC ID 7517480577, 113 clinicians
Mtca Psychological Services P.a.Group PAC ID 6406010834, 4 clinicians

Practice addresses (Care Compare)

10605 S Jog Rd
MTC the Barclay at Boynton Beach
Boynton Beach, FL 33437-3234
Phone (786) 414-6666

1080 NW 15TH St
Boca Raton, FL 33486-1331
Phone (786) 414-6666

111 Executive Ctr Dr
West Palm Beach, FL 33401-4849
Phone (561) 697-5500

16853 NE 2 Ave
North Miami Beach, FL 33162-1776
Phone (786) 414-6666

8500 Royal Palm Blvd
Coral Springs, FL 33065-5715
Phone (786) 414-6666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mtca Psychological Services P.a. CurrentSince Feb 15, 2021 Accepting new patients
Senior Living Memory Health, Inc. CurrentSince Feb 12, 2025 Accepting new patients

Locations

2000 Lowson Blvd
Delray Beach, FL 33445
Phone (561) 454-2000

7091 Atlantic Ave
Delray Beach, FL 33446
Phone (561) 558-2149

6067 Hollywood Blvd
Ste 200
Hollywood, FL 33024

16853 NE 2nd Ave
Ste S304
North Miami Beach, FL 33162

16853 NE 2nd Ave
Ste 304
North Miami Beach, FL 33162
Phone (954) 907-1817

111 Executive Center Dr
West Palm Beach, FL 33401
Phone (561) 300-4052

Organizations & group practices 2

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": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1326523747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6067 HOLLYWOOD BLVD STE 200",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247922",
            "telephone_number": "516-567-3038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6067 HOLLYWOOD BLVD STE 200",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247922",
            "telephone_number": "786-414-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDGETTE",
        "first_name": "KRISTEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

Verify at the official NPI Registry.