Individual provider Active NPI

Debra D Laclair, LCSW

  • Clinical Social Worker
  • Punta Gorda, FL
National Provider Identifier
1487967949
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9751 Issued in FL
Practice address
24451 Sandhill Blvd Unit B
Punta Gorda, FL 33983-5214
Phone
(941) 347-8447
NPI assigned
Jul 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 076877 NY
Clinical Social Worker 1041C0700X SW9751 FL Primary

Addresses

Primary practice location

24451 Sandhill Blvd Unit B
Punta Gorda, FL 33983-5214

Mailing address

24451 Sandhill Blvd Unit B
Punta Gorda, FL 33983-5214

Other identifiers 1

IdentifierTypeStateIssuer
06381864MedicaidNY

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076877NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1487967949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24451 SANDHILL BLVD UNIT B",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339835214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24451 SANDHILL BLVD UNIT B",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339835214",
            "telephone_number": "941-347-8447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACLAIR",
        "first_name": "DEBRA",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-26",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "076877",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06381864",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Punta Gorda, FL

Sources for this page

Verify at the official NPI Registry.