Individual provider Active NPI

Rachel Marie Westphal

  • Clinical Social Worker
  • Brandon, FL
National Provider Identifier
1629846316
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW22428 Issued in FL
Practice address
220 W Brandon Blvd Ste 203
Brandon, FL 33511-5100
Phone
(813) 501-5260
Fax
(813) 437-1439
NPI assigned
Dec 13, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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 SW22428 FL Primary

Addresses

Primary practice location

220 W Brandon Blvd Ste 203
Brandon, FL 33511-5100

Mailing address

1803 Citrus Orchard Way
Valrico, FL 33594-4016
Phone (813) 527-4328

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
I20240506000338 FL Practitioner - Clinical Social Worker 3678913852 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW22428FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Mental Health & Wellness, LLC Clinical CurrentSince Apr 22, 2024 Accepting new patients

Locations

1767 Lakewood Ranch Blvd
Bradenton, FL 34211
Phone (941) 423-2728

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": "1702425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1629846316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 CITRUS ORCHARD WAY",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335944016",
            "telephone_number": "813-527-4328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W BRANDON BLVD STE 203",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115100",
            "telephone_number": "813-501-5260",
            "fax_number": "813-437-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTPHAL",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.