Active NPI
Phillip Larry Brandon Jr., LCSW
- Clinical Social Worker
- Kissimmee, FL
National Provider Identifier
1578476420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149031768
- Practice address
- 253 Chadworth Dr
Kissimmee, FL 34758-3041 - Phone
- (804) 485-9099
- NPI assigned
- Sep 23, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149031768 | IL | Primary |
Addresses
Primary practice location
253 Chadworth Dr
Kissimmee, FL 34758-3041
Mailing address
253 Chadworth Dr
Kissimmee, FL 34758-3041
Phone (804) 485-9099
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790121600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790121600000",
"number": "1578476420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "253 CHADWORTH DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347583041",
"telephone_number": "804-485-9099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "253 CHADWORTH DR",
"city": "KISSIMMEE",
"state": "FL",
"postal_code": "347583041",
"telephone_number": "804-485-9099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRANDON",
"first_name": "PHILLIP",
"middle_name": "LARRY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-09-23",
"last_updated": "2026-09-23",
"certification_date": "2026-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149031768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kissimmee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.