Individual provider Active NPI

Minerva Melody King, LCSW

  • Clinical Social Worker
  • West Palm Beach, FL
National Provider Identifier
1336441401
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11224 Issued in FL
Practice address
1870 Forest Hill Blvd
Suite 200
West Palm Beach, FL 33406-8901
Phone
(561) 904-6514
Fax
(561) 776-4213
NPI assigned
Nov 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 SW11224 FL Primary

Addresses

Primary practice location

1870 Forest Hill Blvd
Suite 200
West Palm Beach, FL 33406-8901

Mailing address

16764 121St Ter N
Jupiter, FL 33478-6006
Phone (561) 909-7011

Other identifiers 1

IdentifierTypeStateIssuer
003275100MedicaidFL

Other names 1

  • Mrs. Minnie Melody King Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11224FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Heal the Trauma Clinical CurrentSince Jan 19, 2025 Accepting new patients

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": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1336441401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16764 121ST TER N",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334786006",
            "telephone_number": "561-909-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 FOREST HILL BLVD",
            "address_2": "SUITE 200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334068901",
            "telephone_number": "561-904-6514",
            "fax_number": "561-776-4213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "MINERVA",
        "middle_name": "MELODY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11224",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003275100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MINNIE",
            "last_name": "KING",
            "middle_name": "MELODY",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.