Active NPI
Raysa Rodriguez, LCSW
- Clinical Social Worker
- Fort Myers, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 23561
- Practice address
- 12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989 - Phone
- (239) 829-5494
- NPI assigned
- Sep 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 23561 | FL | Primary |
Addresses
Primary practice location
12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989
Mailing address
12791 World Plaza LN BLDG 89
Fort Myers, FL 33907-3989
Phone (239) 829-5494
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12791 World Plaza LN
BLDG 89
Fort Myers, FL 33907-3989
Phone (239) 829-5494
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23561 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fort Myers Psychology, PA | Single Specialty | Current | Accepting new patients |
Locations
15950 McGregor Blvd
Fort Myers, FL 33908
Phone (239) 454-1277
10500 Cypress Cove Dr
Fort Myers, FL 33908
Phone (239) 214-2525
12791 World Plaza Ln
Bldg 89
Fort Myers, FL 33907
Phone (239) 247-1756
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, 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": "1726099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726099200000",
"number": "1407682701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12791 WORLD PLAZA LN BLDG 89",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339073989",
"telephone_number": "239-829-5494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12791 WORLD PLAZA LN BLDG 89",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339073989",
"telephone_number": "239-829-5494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "RAYSA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-09-12",
"last_updated": "2024-09-12",
"certification_date": "2024-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "23561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.