Individual provider Active NPI

Pandora Ann Scotto, LCSW

  • Clinical Social Worker
  • Fort Pierce, FL
National Provider Identifier
1396933453
Registry record updated May 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW8105 Issued in FL
Practice address
776 W Midway Rd
Fort Pierce, FL 34982-4203
Phone
(772) 519-0976
NPI assigned
Oct 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2014

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 SW8105 FL Primary

Addresses

Primary practice location

776 W Midway Rd
Fort Pierce, FL 34982-4203

Mailing address

8600 Indrio Rd
Fort Pierce, FL 34951-1612
Phone (772) 510-0976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2022 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW8105FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Achieving Wellness Chiropractic Center, LLC PastSince Sep 1, 2014 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": "1192147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400803200000",
    "number": "1396933453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8600 INDRIO RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349511612",
            "telephone_number": "772-510-0976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 W MIDWAY RD",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349824203",
            "telephone_number": "772-519-0976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTTO",
        "first_name": "PANDORA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-12",
        "last_updated": "2014-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.