Individual provider Active NPI

Kristen M Nitsberg I, LMSW

  • Clinical Social Worker
  • Coral Springs, FL
National Provider Identifier
1346485174
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW15810 Issued in FL
Practice address
Therapy by Mindy
5421 North University Dive Suite #102
Coral Springs, FL 33067
Phone
(732) 580-8383
NPI assigned
Dec 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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 R080799-01 NY
Clinical Social Worker 1041C0700X SW15810 FL Primary

Addresses

Primary practice location

Therapy by Mindy
5421 North University Dive Suite #102
Coral Springs, FL 33067

Mailing address

116 John St
27TH Floor
New York, NY 10038-3300
Phone (212) 385-0086

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
I20190403001919 FL Practitioner - Clinical Social Worker 0749521615 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
Mindy Staum LCSW PAGroup PAC ID 5890952998, 16 clinicians

Practice addresses (Care Compare)

5421 N University Dr
Suite 102
Coral Springs, FL 33067-4638
Phone (732) 580-8383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW15810FLMDClinical Social Worker
R080799-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cis Counseling Center Inc Mental Health Past Accepting new patients
Cis Counseling Center Past Accepting new patients

Organizations & group practices 3

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": "1228694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1346485174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 JOHN ST",
            "address_2": "27TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100383300",
            "telephone_number": "212-385-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THERAPY BY MINDY",
            "address_2": "5421 NORTH UNIVERSITY DIVE SUITE #102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "33067",
            "telephone_number": "732-580-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITSBERG",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-08",
        "last_updated": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R080799-01",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW15810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.