Individual provider Active NPI

Liam Thomas Mugavin, LCSW

  • Clinical Social Worker
  • Wilton Manors, FL
National Provider Identifier
1447915624
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22308 Issued in FL
Practice address
520 NE 20TH St Apt 1001
Wilton Manors, FL 33305-2160
Phone
(786) 708-1229
NPI assigned
Nov 3, 2021
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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 22308 FL Primary

Addresses

Primary practice location

520 NE 20TH St Apt 1001
Wilton Manors, FL 33305-2160

Mailing address

520 NE 20TH St Apt 1001
Wilton Manors, FL 33305-2160
Phone (786) 708-1229

Other practice location 1

66 W Flagler St Ste 900
Miami, FL 33130-1807
Phone (786) 244-7711

Other practice location 2

66 W Flagler St Ste 900
Miami, FL 33130-1807
Phone (646) 941-7645

Other names 1

  • Taylor C. Mugavin Former name

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
I20240717004922 FL Practitioner - Clinical Social Worker 6800331596 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22308FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jun 5, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1635897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1447915624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 NE 20TH ST APT 1001",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333052160",
            "telephone_number": "786-708-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 NE 20TH ST APT 1001",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333052160",
            "telephone_number": "786-708-1229"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "66 W Flagler St Ste 900",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331301807",
            "country_code": "US",
            "telephone_number": "786-244-7711",
            "fax_number": "954-480-1784",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "66 W Flagler St Ste 900",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331301807",
            "country_code": "US",
            "telephone_number": "646-941-7645",
            "fax_number": "929-596-7897",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUGAVIN",
        "first_name": "LIAM",
        "middle_name": "THOMAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2021-11-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "22308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAYLOR",
            "last_name": "MUGAVIN",
            "middle_name": "C.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilton Manors, FL

Sources for this page

Verify at the official NPI Registry.