Individual provider Active NPI

Cynthia Alyce Maston, LCSW

  • Clinical Social Worker
  • St Petersburg, FL
National Provider Identifier
1336303171
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7927 Issued in FL
Practice address
928 22ND Ave S
St Petersburg, FL 33705-2934
Phone
(727) 327-7656
Fax
(727) 322-2130
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 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 SW7927 FL Primary

Addresses

Primary practice location

928 22ND Ave S
St Petersburg, FL 33705-2934

Mailing address

4726 N Habana Ave
Tampa, FL 33614-7144
Phone (813) 872-7582

Other identifiers 1

IdentifierTypeStateIssuer
111454700MedicaidFL

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
I20080912000484 FL Practitioner - Clinical Social Worker 5092881102 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cotler Healthcare & Development Inc. CurrentSince Dec 27, 2022 Accepting new patients

Locations

901 S 62nd Ave
Hollywood, FL 33023
Phone (954) 893-0109

9835 Lake Worth Rd
Ste 16179
Lake Worth, FL 33467

5601 31st St S
St Petersburg, FL 33712
Phone (727) 848-3578

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1336303171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4726 N HABANA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147144",
            "telephone_number": "813-872-7582",
            "fax_number": "813-873-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 22ND AVE S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337052934",
            "telephone_number": "727-327-7656",
            "fax_number": "727-322-2130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTON",
        "first_name": "CYNTHIA",
        "middle_name": "ALYCE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111454700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.