Individual provider Active NPI

Nicole Worthalter Sutton

  • Clinical Social Worker
  • Miami, FL
National Provider Identifier
1457948531
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW14075 Issued in FL
Practice address
20824 W Dixie Hwy
Miami, FL 33180-1147
Phone
(305) 654-0907
NPI assigned
Dec 23, 2020
Last updated
Dec 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 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 LCSW14075 FL Primary

Addresses

Primary practice location

20824 W Dixie Hwy
Miami, FL 33180-1147

Mailing address

20824 W Dixie Hwy
Miami, FL 33180-1147
Phone (305) 654-0907

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW14075FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peysaf Worthalter, M.D., P.a. CurrentSince Dec 27, 2020 Accepting new patients

Locations

20824 W Dixie Hwy
Miami, FL 33180
Phone (305) 654-0907

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": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1457948531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20824 W DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331801147",
            "telephone_number": "305-654-0907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20824 W DIXIE HWY",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331801147",
            "telephone_number": "305-654-0907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHALTER SUTTON",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "LCSW14075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.