Active NPI
Jonathan L Fucella, LCSW
- Clinical Social Worker
- Fort Myers, FL
National Provider Identifier
1467949628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW14662
- Practice address
- 12550 New Brittany Blvd
Fort Myers, FL 33907 - Phone
- (239) 343-9180
- Fax
- (239) 343-9188
- NPI assigned
- Apr 13, 2018
- Sex
- Male
- 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 | SW14662 | FL | Primary |
Addresses
Primary practice location
12550 New Brittany Blvd
Fort Myers, FL 33907
Mailing address
PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9180
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101937100 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1523577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599004800000",
"number": "1467949628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2147",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339022147",
"telephone_number": "239-343-9180",
"fax_number": "239-343-9188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12550 NEW BRITTANY BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33907",
"telephone_number": "239-343-9180",
"fax_number": "239-343-9188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUCELLA",
"first_name": "JONATHAN",
"middle_name": "L",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-04-13",
"last_updated": "2020-09-02",
"certification_date": "2020-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW14662",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101937100",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
- Ft. Myers Chiropractic Center, Inc.
- Ft. Myers Dental Services, PA (Main Street Children's Dentistry of Ft. Myers)
- Ft. Myers MRI, LLC
- Ft. Myers Women's Health Center, Inc.
- Ft.Myers Dental Services, P.a. (Towncare Dental of Ft.Myers)
- Paul D Fuchs, DO
- Carol Fuechsel
- Gustavo Enrique Fuentes, D.M.D.
- Adam Fueredi, M.D.
- Jennifer Morton Fugatt, PT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.