Individual provider Active NPI

Mary Ellen McHugh, LCSW

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1376874743
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9702 Issued in FL
Practice address
5864 Auvers Blvd
# 104
Orlando, FL 32807-3777
Phone
(407) 963-2388
NPI assigned
Jan 24, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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 SW9702 FL Primary

Addresses

Primary practice location

5864 Auvers Blvd
# 104
Orlando, FL 32807-3777

Mailing address

5864 Auvers Blvd
# 104
Orlando, FL 32807-3777
Phone (407) 963-2388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220503002492 TX Practitioner - Clinical Social Worker 9436331998 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW9702FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Plains Community MHMR Center CurrentSince Apr 1, 2022 Accepting new patients
Coastal Plains Community MHMR Center CurrentSince Apr 1, 2022 Accepting new patients
Etsah Counseling Center, PLLC CurrentSince Oct 1, 2023 Accepting new patients
Coastal Plains Community MHMR Center Past Accepting new patients

Locations

200 Marriott Dr
Portland, TX 78374
Phone (361) 777-3991

3500 Hillcrest Dr
Ste 2B
Waco, TX 76708
Phone (254) 230-8501

Organizations & group practices 4

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": "1264291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1376874743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5864 AUVERS BLVD",
            "address_2": "# 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073777",
            "telephone_number": "407-963-2388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5864 AUVERS BLVD",
            "address_2": "# 104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328073777",
            "telephone_number": "407-963-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCHUGH",
        "first_name": "MARY",
        "middle_name": "ELLEN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-24",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.