Individual provider Active NPI

Janet Santiago, LCSW

  • Clinical Social Worker
  • Port Saint Lucie, FL
National Provider Identifier
1578865895
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10997 Issued in FL
Practice address
1102 SW Idol Ave
Port Saint Lucie, FL 34953-6816
Phone
(772) 626-2321
NPI assigned
Nov 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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 SW10997 FL Primary

Addresses

Primary practice location

1102 SW Idol Ave
Port Saint Lucie, FL 34953-6816

Mailing address

1102 SW Idol Ave
Port Saint Lucie, FL 34953-6816
Phone (772) 626-2321

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
I20130830000363 FL Practitioner - Clinical Social Worker 9638312176 Practice locations: Palm City, FL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Janet Santiago LCSW Clinical CurrentSince Jun 28, 2020 Accepting new patients
Janet Santiago, LCSW Clinical Past Accepting new patients

Locations

901 SW Martin Downs Blvd
Ste 310
Palm City, FL 34990
Phone (772) 626-2321

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": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1578865895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 SW IDOL AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349536816",
            "telephone_number": "772-626-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 SW IDOL AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349536816",
            "telephone_number": "772-626-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "JANET",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

Verify at the official NPI Registry.