Individual provider Active NPI

Nellie Garcia Kovacs, LCSW

  • Clinical Social Worker
  • Orange Park, FL
National Provider Identifier
1649413808
Registry record updated May 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9152 Issued in FL
Practice address
1724 Village Way
Orange Park, FL 32073-5264
Phone
(904) 269-0886
NPI assigned
Apr 16, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9152 FL Primary
Clinical Social Worker 1041C0700X 051112 NY

Addresses

Primary practice location

1724 Village Way
Orange Park, FL 32073-5264

Mailing address

1724 Village Way
Orange Park, FL 32073-5264

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
I20131018001416 FL Practitioner - Clinical Social Worker 6002878857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beth Davalos Counseling Center LLCGroup PAC ID 3375978414, 32 clinicians

Practice addresses (Care Compare)

540 E Horatio Ave
Suite 200
Maitland, FL 32751-7314
Phone (407) 401-9020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9152FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Davalos Counseling Center LLC Clinical CurrentSince Jan 9, 2025 Accepting new patients
Spanish Speaking Ederly Council-Raices Clinical Past Accepting new patients
Spanish Speaking Elderly Council- Raices Clinical Past Accepting new patients

Locations

540 E Horatio Ave
Ste 200
Maitland, FL 32751
Phone (407) 401-9020

Organizations & group practices 3

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": "1239840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272672000000",
    "number": "1649413808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1724 VILLAGE WAY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1724 VILLAGE WAY",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735264",
            "telephone_number": "904-269-0886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA KOVACS",
        "first_name": "NELLIE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-16",
        "last_updated": "2010-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "9152",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "051112",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.