Individual provider Active NPI

Jenna Maggio, LCSW, MCAP

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1497330260
Registry record updated Mar 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
17608 Issued in FL
Practice address
434 W Kennedy Blvd
Orlando, FL 32810-6237
Phone
(407) 875-3700
NPI assigned
Mar 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 100880 FL
Clinical Social Worker 1041C0700X 17608 FL Primary

Addresses

Primary practice location

434 W Kennedy Blvd
Orlando, FL 32810-6237

Mailing address

414 Navarre Way
Altamonte Springs, FL 32714-2225
Phone (616) 558-8367

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
100880FLMDAddiction (Substance Use Disorder) Counselor
17608FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615593600000",
    "number": "1497330260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 NAVARRE WAY",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142225",
            "telephone_number": "616-558-8367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 W KENNEDY BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328106237",
            "telephone_number": "407-875-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGIO",
        "first_name": "JENNA",
        "credential": "LCSW, MCAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-13",
        "last_updated": "2021-03-13",
        "certification_date": "2021-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "100880",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "17608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2021; 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.