Individual provider Active NPI

Toni Gorn, LCSW

  • Clinical Social Worker
  • Land O' Lakes, FL
National Provider Identifier
1376111286
Registry record updated Apr 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
16703 Early Riser Ave
Land O Lakes, FL 34638-0192
Phone
(727) 201-2984
NPI assigned
Jun 16, 2021
Last updated
Apr 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2024

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 CW024106 PA
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

16703 Early Riser Ave
Land O Lakes, FL 34638-0192

Mailing address

4508 Havelocke Dr # 4508
Land O Lakes, FL 34638-7776
Phone (727) 967-1558

Other practice location 1

283 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 270-2422

Other practice location 2

239 S Butler Rd
Lebanon, PA 17042-8939
Phone (717) 270-2422

Other identifiers 2

IdentifierTypeStateIssuer
104313445MedicaidPA
15953481OtherPACAQH

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
I20230601001096 FL Practitioner - Clinical Social Worker 6204293533 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW024106PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Behavioral Health Inc. Current Accepting new patients
Baycare Behavioral Health Inc. CurrentSince May 18, 2023 Accepting new patients
Baycare Behavioral Health, Inc CurrentSince May 18, 2023 Accepting new patients
Baycare Behavioral Health Inc. Past Accepting new patients
Yolanda Harper LCSW LLC Clinical PastSince Jun 1, 2021 Accepting new patients
Baycare Behavioral Health Inc. Past Accepting new patients
Behavioral Health Management Services, Inc. Past Accepting new patients
Baycare Behavioral Health Inc. Past Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

14527 7th St
Dade City, FL 33523
Phone (352) 521-1474

7809 Massachusetts Ave
Ste 100
New Prt Rchy, FL 34653
Phone (727) 841-4200

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1376111286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4508 HAVELOCKE DR # 4508",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387776",
            "telephone_number": "727-967-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16703 EARLY RISER AVE",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346380192",
            "telephone_number": "727-201-2984"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "283 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-270-2422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "239 S Butler Rd",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170428939",
            "country_code": "US",
            "telephone_number": "717-270-2422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORN",
        "first_name": "TONI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW024106",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104313445",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15953481",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Land O' Lakes, FL

Sources for this page

Verify at the official NPI Registry.