Individual provider Active NPI

Jordan Deboer, LCSW

  • Clinical Social Worker
  • The Villages, FL
National Provider Identifier
1639031057
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW25659 Issued in FL
Practice address
1400 N US Highway 441
The Villages, FL 32159-8975
Phone
(352) 674-8700
NPI assigned
Nov 25, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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 SW25659 FL Primary

Addresses

Primary practice location

1400 N US Highway 441
The Villages, FL 32159-8975

Mailing address

11213 Roz Way
Oxford, FL 34484-3498

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
I20260224004606 FL Practitioner - Clinical Social Worker 0547741886 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6503 Powell Rd
The Villages, FL 32163-2038

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW25659FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care Vitality Inc CurrentSince Feb 1, 2026 Accepting new patients
Centerwell Senior Primary Care Vitality Inc CurrentSince Feb 1, 2026 Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

1346 Dewey Dr
The Villages, FL 34762
Phone (352) 674-1780

1400 N US Highway 441
Ste 930
The Villages, FL 32159
Phone (352) 750-2108

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": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1639031057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11213 ROZ WAY",
            "city": "OXFORD",
            "state": "FL",
            "postal_code": "344843498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 N US HIGHWAY 441",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321598975",
            "telephone_number": "352-674-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBOER",
        "first_name": "JORDAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW25659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Villages, FL

Sources for this page

Verify at the official NPI Registry.