Alicia Dyane Pelham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW20274 Issued in FL

Practice address

506 E Virginia Ave
Tampa, FL 33603-4826

Phone

(813) 442-3892

NPI assigned

Sep 16, 2022

Last updated

Sep 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Premier Community Healthcare Group Inc

  • Federally Qualified Health Center (FQHC)
  • Dade City, FL
  • NPI 1841263399
  Medicare reassignment NPD
• Premier Community Healthcare Group, Inc.

  • Federally Qualified Health Center (FQHC)
  • Zephyrhills, FL
  • NPI 1508445362
  NPD

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1326760265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 E VIRGINIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336034826",
            "telephone_number": "813-205-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 E VIRGINIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336034826",
            "telephone_number": "813-442-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELHAM",
        "first_name": "ALICIA",
        "middle_name": "DYANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW20274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "onegirlenterprises@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "messaging",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "506 E Virginia Ave",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336034826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Luis Gullermo Pelaez, LMT
• Aundrea Pelakatiyage
• Leah Pelcastre
• Maria F. Pelegrina, RD, LDN
• Jennifer Ann Pelesh, CCC-SLP
• Jose Pell, CRNA
• Roxanne Pelletier
• Celeste Pellon
• Kelly Noel Pelloni
• Alina Yanira Pellot Aviles, RPH, PHARM D

• Clinical Social Worker in Tampa, FL
• Providers in Tampa, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.