Individual provider Active NPI

Brendalis Rios

  • Clinical Social Worker
  • Orlando, FL
National Provider Identifier
1639598550
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
60764675 Issued in WA
Practice address
1030 Maple View Way
Orlando, FL 32828-6930
Phone
(787) 431-9520
NPI assigned
Apr 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CG60433373 WA
Clinical Social Worker 1041C0700X 149022529 IL
Clinical Social Worker 1041C0700X 099145 IA
Clinical Social Worker 1041C0700X 60764675 WA Primary

Addresses

Primary practice location

1030 Maple View Way
Orlando, FL 32828-6930

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL, WA, FL4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20200422000453 IA Practitioner - Clinical Social Worker 8628408275 Reassigns benefits to 1 organization
I20220131000739 IL Practitioner - Clinical Social Worker 8628408275 Reassigns benefits to 1 organization
I20240227004003 WA Practitioner - Clinical Social Worker 8628408275 Reassigns benefits to 1 organization
I20250813001201 FL Practitioner - Clinical Social Worker 8628408275 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CG60433373WAMDAddiction (Substance Use Disorder) Counselor
099145IAMDClinical Social Worker
149022529ILMDClinical Social Worker
60764675WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Mar 28, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

699 Walnut St
Ste 4
Des Moines, IA 50309
Phone (515) 278-9920

605 N Michigan Ave
Fl 4
Chicago, IL 60611
Phone (773) 232-5338

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694044800000",
    "number": "1639598550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 MAPLE VIEW WAY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328286930",
            "telephone_number": "787-431-9520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIOS",
        "first_name": "BRENDALIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CG60433373",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149022529",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "099145",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "60764675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.