Individual provider Active NPI

Fayanne Kuttler, LCSW

  • Social Worker
  • Aventura, FL
National Provider Identifier
1376521237
Registry record updated May 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW001836 Issued in FL
Practice address
2751 NE 183Rd St
Aventura, FL 33160-2160
Phone
(305) 401-5484
Fax
(954) 337-3309
NPI assigned
Jan 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW001836 FL Primary

Addresses

Primary practice location

2751 NE 183Rd St
Aventura, FL 33160-2160

Mailing address

PO Box 801936
Miami, FL 33280-1936
Phone (954) 224-0555

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
I20130425000052 FL Practitioner - Clinical Social Worker 5496991168 Practice locations: Miami, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

19870 NE 23Rd Ave
Miami, FL 33180-2141
Phone (954) 357-1172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW001836FLMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Stanley and Pearl Goodman JFS of Broward County Inc PastSince Jul 1, 1990 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": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526774400000",
    "number": "1376521237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801936",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "332801936",
            "telephone_number": "954-224-0555",
            "fax_number": "954-840-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2751 NE 183RD ST",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331602160",
            "telephone_number": "305-401-5484",
            "fax_number": "954-337-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUTTLER",
        "first_name": "FAYANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-02",
        "last_updated": "2018-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW001836",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

Verify at the official NPI Registry.