Individual provider Active NPI

Akia Imani Izzard, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1568248847
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW023914 Issued in PA
Practice address
1234 N 28TH St
Philadelphia, PA 19121-4536
Phone
(215) 432-5874
NPI assigned
Sep 4, 2023
Last updated
Sep 4, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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 CW023914 PA Primary

Addresses

Primary practice location

1234 N 28TH St
Philadelphia, PA 19121-4536

Mailing address

1234 N 28TH St
Philadelphia, PA 19121-4536
Phone (215) 432-5874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240123001273 PA Practitioner - Clinical Social Worker 8527410893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CW023914PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Dec 29, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1693785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1568248847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 N 28TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191214536",
            "telephone_number": "215-432-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 N 28TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191214536",
            "telephone_number": "215-432-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZARD",
        "first_name": "AKIA",
        "middle_name": "IMANI",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-04",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW023914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.