Individual provider Active NPI

Jill Fischer-Peters, L.C.S.W.

  • Clinical Social Worker
  • Seminole, FL
National Provider Identifier
1659316024
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7731 Issued in FL
Practice address
13800 Park Blvd Ste 206
Seminole, FL 33776-3439
Phone
(727) 391-9800
Fax
(727) 391-9882
NPI assigned
Jun 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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 SW7731 FL Primary

Addresses

Primary practice location

13800 Park Blvd Ste 206
Seminole, FL 33776-3439

Mailing address

13800 Park Blvd Ste 206
Seminole, FL 33776-3439
Phone (727) 391-9800

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
I20060405000106 FL Practitioner - Clinical Social Worker 0345258141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10225 Ulmerton Rd
Suite 6a
Largo, FL 33771-3520
Phone (727) 391-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW7731FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Living Well Psychotherapy Associates Inc CurrentSince Jul 17, 2003 Accepting new patients

Locations

10225 Ulmerton Rd
Ste 6A
Largo, FL 33771
Phone (727) 391-9800

13800 Park Blvd
Ste 206
Seminole, FL 33776
Phone (727) 391-9800

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": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355702400000",
    "number": "1659316024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13800 PARK BLVD STE 206",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337763439",
            "telephone_number": "727-391-9800",
            "fax_number": "727-391-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13800 PARK BLVD STE 206",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337763439",
            "telephone_number": "727-391-9800",
            "fax_number": "727-391-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER-PETERS",
        "first_name": "JILL",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2012-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seminole, FL

Sources for this page

Verify at the official NPI Registry.