Individual provider Active NPI

Victoria Michele Defalco Charland, L.C.S.W.

  • Clinical Social Worker
  • Lakewood Ranch, FL
National Provider Identifier
1487062626
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW8520 Issued in FL
Practice address
11705 Evening Walk Dr
Lakewood Ranch, FL 34211-9508
Phone
(941) 423-2728
NPI assigned
Jul 31, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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 SW8520 FL Primary

Addresses

Primary practice location

11705 Evening Walk Dr
Lakewood Ranch, FL 34211-9508

Mailing address

PO Box 728
Nokomis, FL 34274-0728
Phone (941) 928-9774

Other practice location 1

11705 Evening Walk Dr
Lakewood Ranch, FL 34211-9508
Phone (941) 423-2728

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
I20140930000046 FL Practitioner - Clinical Social Worker 6406076207 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Victoria M Defalco Charland LCSW Clinical PastSince Jan 12, 2025 Accepting new patients

Organizations & group practices 2

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": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1487062626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 728",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342740728",
            "telephone_number": "941-928-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11705 EVENING WALK DR",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342119508",
            "telephone_number": "941-423-2728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11705 Evening Walk Dr",
            "address_purpose": "LOCATION",
            "city": "Lakewood Ranch",
            "state": "FL",
            "postal_code": "342119508",
            "country_code": "US",
            "telephone_number": "941-423-2728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHARLAND",
        "first_name": "VICTORIA",
        "middle_name": "MICHELE DEFALCO",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-31",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

Verify at the official NPI Registry.