Individual provider Active NPI

Marilyn Stillwell, LCSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1518297282
Registry record updated Jan 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW4846 Issued in FL
Practice address
7802 N 58TH St
Tampa, FL 33617-7730
Phone
(813) 988-0770
NPI assigned
Jan 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 1, 2010

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 SW4846 FL Primary

Addresses

Primary practice location

7802 N 58TH St
Tampa, FL 33617-7730

Mailing address

7802 N 58TH St
Tampa, FL 33617-7730
Phone (813) 988-0770

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
I20170815003694 FL Practitioner - Clinical Social Worker 0749552446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brandon Mental HealthGroup PAC ID 8527136977, 15 clinicians

Practice addresses (Care Compare)

1134 Bell Shoals Rd
Brandon, FL 33511-8813
Phone (813) 315-8648

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW4846FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Brandon Mental Health CurrentSince Jun 22, 2017 Accepting new patients
Auto Injury EMS's of Florida Past Accepting new patients

Locations

421 Lithia Pinecrest Rd
Brandon, FL 33511
Phone (813) 315-8648

1134 Bell Shoals Rd
Brandon, FL 33511
Phone (813) 315-8648

Networks

  • Freedom Health HMO Network

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": "1262304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262304000000",
    "number": "1518297282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7802 N 58TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336177730",
            "telephone_number": "813-988-0770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7802 N 58TH ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336177730",
            "telephone_number": "813-988-0770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLWELL",
        "first_name": "MARILYN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-01",
        "last_updated": "2010-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.