Individual provider Active NPI

Kristi Kay Damron, LCSW

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1629615539
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15791 Issued in FL
Practice address
1020 E Lafayette St
Tallahassee, FL 32301-4569
Phone
(850) 290-2211
NPI assigned
Dec 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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 15791 FL Primary

Addresses

Primary practice location

1020 E Lafayette St
Tallahassee, FL 32301-4569

Mailing address

1020 E Lafayette St Ste 103
Tallahassee, FL 32301-4546
Phone (850) 290-2211

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
I20211206002527 FL Practitioner - Clinical Social Worker 8022408004 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1350 N Gadsden St
Duplex a
Tallahassee, FL 32303-5614
Phone (850) 290-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15791FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Damron Counseling, LLC CurrentSince Oct 18, 2021 Accepting new patients

Locations

1020 E Lafayette St
Ste 103
Tallahassee, FL 32301
Phone (850) 290-2211

1350 N Gadsden St
#A
Tallahassee, FL 32303
Phone (850) 290-2211

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": "1575936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1629615539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 E LAFAYETTE ST STE 103",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323014546",
            "telephone_number": "850-290-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 E LAFAYETTE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323014569",
            "telephone_number": "850-290-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMRON",
        "first_name": "KRISTI",
        "middle_name": "KAY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-10",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "15791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.