Individual provider Active NPI

Kristel Natasha Avilus

  • Clinical Social Worker
  • Tallahassee, FL
National Provider Identifier
1689268591
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17998 Issued in FL
Practice address
114 Ridge Rd
Tallahassee, FL 32305-7002
Phone
(850) 544-6937
NPI assigned
Feb 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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 SW17998 FL Primary

Addresses

Primary practice location

114 Ridge Rd
Tallahassee, FL 32305-7002

Mailing address

114 Ridge Rd
Tallahassee, FL 32305-7002
Phone (850) 544-6937

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

LicenseStateTypeSpecialty
SW17998FLMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1689268591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 RIDGE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323057002",
            "telephone_number": "850-544-6937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 RIDGE RD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323057002",
            "telephone_number": "850-544-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILUS",
        "first_name": "KRISTEL",
        "middle_name": "NATASHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.