Individual provider Active NPI

Rebecca Brinklow-Vaughan, LCSW

  • Clinical Social Worker
  • Altamonte Springs, FL
National Provider Identifier
1649974452
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW21541 Issued in FL
Practice address
108 W Citrus St
Altamonte Springs, FL 32714-2502
Phone
(386) 218-6335
Fax
(321) 234-0252
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 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 SW21541 FL Primary

Addresses

Primary practice location

108 W Citrus St
Altamonte Springs, FL 32714-2502

Mailing address

654 Airmont Ave
Altamonte Springs, FL 32714-4701
Phone (321) 514-7940

Other practice location 1

654 Airmont Ave
Altamonte Springs, FL 32714-4701
Phone (321) 514-7940

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
I20231025003707 FL Practitioner - Clinical Social Worker 3678929775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of South Carolina School of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healing Psychiatry of Florida IncGroup PAC ID 0345659868, 10 clinicians

Practice addresses (Care Compare)

108 W Citrus St
Altamonte Springs, FL 32714-2502
Phone (321) 972-9215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Psychiatry of Florida Inc CurrentSince Oct 19, 2023 Accepting new patients

Locations

108 W Citrus St
Altamonte Springs, FL 32714
Phone (321) 972-9215

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1649974452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 AIRMONT AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327144701",
            "telephone_number": "321-514-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W CITRUS ST",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327142502",
            "telephone_number": "386-218-6335",
            "fax_number": "321-234-0252"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "654 Airmont Ave",
            "address_purpose": "LOCATION",
            "city": "Altamonte Springs",
            "state": "FL",
            "postal_code": "327144701",
            "country_code": "US",
            "telephone_number": "321-514-7940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRINKLOW-VAUGHAN",
        "first_name": "REBECCA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamonte Springs, FL

Sources for this page

Verify at the official NPI Registry.