Active NPI
Ishmus Lawanzo Hill Jr., LCSW
- Clinical Social Worker
- Lakeland, FL
National Provider Identifier
1639964323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 19912
- Practice address
- 6512 Shepherd Oaks Rd
Lakeland, FL 33811-3164 - Phone
- (863) 709-3779
- NPI assigned
- Apr 12, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 19912 | FL | Primary |
Addresses
Primary practice location
6512 Shepherd Oaks Rd
Lakeland, FL 33811-3164
Mailing address
6512 Shepherd Oaks Rd
Lakeland, FL 33811-3164
Phone (863) 709-3779
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
| License | State | Type | Specialty |
|---|---|---|---|
| 19912 | FL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1744416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744416000000",
"number": "1639964323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6512 SHEPHERD OAKS RD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338113164",
"telephone_number": "863-709-3779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6512 SHEPHERD OAKS RD",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338113164",
"telephone_number": "863-709-3779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILL",
"first_name": "ISHMUS",
"middle_name": "LAWANZO",
"name_suffix": "Jr.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-04-12",
"last_updated": "2025-04-12",
"certification_date": "2025-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "19912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakeland, FL
- Highlands Occupational Therapy, Inc (The Hand Rehabilitation Center of Florida)
- Highlands Occupational Therapy, Inc (The Hand Rehabilitation Center of Florida)
- Highpoint Homehealth Services
- Monique Harrigan Hikel
- Cynthia Hilery, NP
- Jena Marie Hill, CRNA
- Lindsey Hill, APRN
- Tasha Marie Hill, CSFA
- Raquel Daphne Hills
- Shannon M Hinckley, ARNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.