Individual provider Active NPI

Michelle L Tullock, LCSW, MCAP

  • Clinical Social Worker
  • Coral Springs, FL
National Provider Identifier
1578767703
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14151 Issued in FL
Practice address
1725 N University Dr Ste 350
Coral Springs, FL 33071-6000
Phone
(855) 501-1004
Fax
(954) 227-2704
NPI assigned
Jun 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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 SW14151 FL Primary

Addresses

Primary practice location

1725 N University Dr Ste 350
Coral Springs, FL 33071-6000

Mailing address

3835 N Freeway Blvd Ste 100
Sacramento, CA 95834-1954
Phone (855) 501-1004

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
I20190911002682 FL Practitioner - Clinical Social Worker 8022347392 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindpath Health Florida, PLLCGroup PAC ID 7517858285, 52 clinicians

Practice addresses (Care Compare)

1725 N University Dr
Suite 350
Coral Springs, FL 33071-6000
Phone (954) 227-2700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14151FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindpath Health Florida, PLLC Clinical CurrentSince Jul 4, 2019 Accepting new patients

Locations

3835 N Freeway Blvd
Ste 100
Sacramento, CA 95834
Phone (916) 576-7898

7000 W Palmetto Park Rd
Ste 407
Boca Raton, FL 33433
Phone (954) 227-2700

1725 N University Dr
Ste 350
Coral Springs, FL 33071
Phone (954) 227-2700

Interoperability endpoints

  • Direct secure messaging: mpfl.michelle.tullock@150275.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779148800000",
    "number": "1578767703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "855-501-1004",
            "fax_number": "954-227-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 N UNIVERSITY DR STE 350",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330716000",
            "telephone_number": "855-501-1004",
            "fax_number": "954-227-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLOCK",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "LCSW, MCAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-12",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.