Individual provider Active NPI

Nancy Maccoll, LMSW

  • Clinical Social Worker
  • Oakland Park, FL
National Provider Identifier
1689869752
Registry record updated Jun 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11011 Issued in FL
Practice address
4849 N Dixie Hwy
Suite 105
Oakland Park, FL 33334-3928
Phone
(954) 226-9585
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2016

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 SW11011 FL Primary

Addresses

Primary practice location

4849 N Dixie Hwy
Suite 105
Oakland Park, FL 33334-3928

Mailing address

4849 N Dixie Hwy
Suite 105
Oakland Park, FL 33334-3928
Phone (954) 226-9585

Other identifiers 2

IdentifierTypeStateIssuer
00244019MedicaidNY
009804200MedicaidFL

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
I20150723007472 FL Practitioner - Clinical Social Worker 9739492448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4849 N Dixie Hwy
Suite 105
Oakland Park, FL 33334-3928
Phone (954) 226-9585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11011FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy Maccoll, L.C.S.W., LLC Clinical CurrentSince Apr 1, 2015 Accepting new patients
Broward House, Inc. PastSince Jun 1, 2016 Accepting new patients

Locations

4849 N Dixie Hwy
Ste 105
Oakland Park, FL 33334
Phone (954) 226-9585

Organizations & group practices 2

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464998400000",
    "number": "1689869752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 N DIXIE HWY",
            "address_2": "SUITE 105",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333343928",
            "telephone_number": "954-226-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 N DIXIE HWY",
            "address_2": "SUITE 105",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333343928",
            "telephone_number": "954-226-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACCOLL",
        "first_name": "NANCY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2016-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00244019",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009804200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

Verify at the official NPI Registry.