Individual provider Active NPI

Sherry Marie Ledbetter

  • Clinical Social Worker
  • Crawfordville, FL
National Provider Identifier
1437771763
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17174 Issued in FL
Practice address
34 Melody LN
Crawfordville, FL 32327-3211
Phone
(852) 354-3931
NPI assigned
May 8, 2020
Last updated
May 8, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2020

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 SW17174 FL Primary

Addresses

Primary practice location

34 Melody LN
Crawfordville, FL 32327-3211

Mailing address

34 Melody LN
Crawfordville, FL 32327-3211
Phone (852) 354-3931

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
I20211111001462 FL Practitioner - Clinical Social Worker 3971992009 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW17174FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A Time to Change Counseling Center Clinical CurrentSince Nov 3, 2021 Accepting new patients

Locations

2140 Crawfordville Hwy
Unit B
Crawfordville, FL 32327
Phone (850) 925-0128

2417 Fleischmann Rd
Ste 4
Tallahassee, FL 32308
Phone (850) 926-1900

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": "1588896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1437771763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 MELODY LN",
            "city": "CRAWFORDVILLE",
            "state": "FL",
            "postal_code": "323273211",
            "telephone_number": "852-354-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 MELODY LN",
            "city": "CRAWFORDVILLE",
            "state": "FL",
            "postal_code": "323273211",
            "telephone_number": "852-354-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDBETTER",
        "first_name": "SHERRY",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-08",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crawfordville, FL

Sources for this page

Verify at the official NPI Registry.