Individual provider Active NPI

Robert Lee Jr., LCSW

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1629484498
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW19339 Issued in FL
Practice address
3464 Avalon Park East Blvd Ste 13251
Orlando, FL 32828-7363
Phone
(321) 966-9363
NPI assigned
Jul 1, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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 SW19339 FL Primary

Addresses

Primary practice location

3464 Avalon Park East Blvd Ste 13251
Orlando, FL 32828-7363

Mailing address

3464 Avalon Park East Blvd Ste 13251
Orlando, FL 32828-7363
Phone (321) 966-9363

Other practice location 1

525 NW Lake Whitney Pl Ste 102&103
Port Saint Lucie, FL 34986-1605
Phone (772) 337-8164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW19339FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Famlee First Clinical Services LLC Mental Health Current Accepting new patients

Locations

3564 E Avalon Park Blvd
Ste 1
Orlando, FL 32828
Phone (305) 842-4947

9314 Forest Hill Blvd
Wellington, FL 33411
Phone (561) 290-2990

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": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1629484498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3464 AVALON PARK EAST BLVD STE 13251",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287363",
            "telephone_number": "321-966-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3464 AVALON PARK EAST BLVD STE 13251",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328287363",
            "telephone_number": "321-966-9363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 NW Lake Whitney Pl Ste 102&103",
            "address_purpose": "LOCATION",
            "city": "Port Saint Lucie",
            "state": "FL",
            "postal_code": "349861605",
            "country_code": "US",
            "telephone_number": "772-337-8164",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ROBERT",
        "name_suffix": "Jr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.