Individual provider Active NPI

Theresa Ann Croce Benedict, LCSW

  • Clinical Social Worker
  • Venice, FL
National Provider Identifier
1427246503
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7665 Issued in FL
Practice address
329 Nokomis Ave S Ste H
Venice, FL 34285-2418
Phone
(941) 830-0165
NPI assigned
Oct 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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 SW7665 FL Primary

Addresses

Primary practice location

329 Nokomis Ave S Ste H
Venice, FL 34285-2418

Mailing address

PO Box 1659
Venice, FL 34284-1659
Phone (941) 830-0165

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
I20090224000462 FL Practitioner - Clinical Social Worker 5294890331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

329 Nokomis Ave S
Suite H
Venice, FL 34285-2418
Phone (941) 830-0165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW7665FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Theresa a Benedict LLC Clinical CurrentSince Sep 9, 2008 Accepting new patients

Locations

1224 Ridgewood Ave
Venice, FL 34285
Phone (941) 284-2868

329 Nokomis Ave S
Ste H
Venice, FL 34285
Phone (317) 250-0371

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": "1192320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1427246503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1659",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342841659",
            "telephone_number": "941-830-0165",
            "fax_number": "941-484-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 NOKOMIS AVE S STE H",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852418",
            "telephone_number": "941-830-0165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROCE BENEDICT",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-14",
        "last_updated": "2023-09-05",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.