Individual provider Active NPI

Mary Elizabeth Creech, LCSW

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1700114014
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW1196 Issued in FL
Practice address
6811 N Central Ave
Tampa, FL 33604-5500
Phone
(813) 951-3002
NPI assigned
Nov 24, 2009
Last updated
Feb 23, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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 SW1196 FL Primary

Addresses

Primary practice location

6811 N Central Ave
Tampa, FL 33604-5500

Mailing address

9918 Torrisdale Loop
Land O Lakes, FL 34638-6139
Phone (813) 951-3002

Other names 1

  • Liz Creech Professional name

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
I20151229001345 FL Practitioner - Clinical Social Worker 1052612512 Practice locations: Tampa, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3333 W Kennedy Blvd
Tampa, FL 33609-2976
Phone (813) 951-3002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW1196FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1700114014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9918 TORRISDALE LOOP",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346386139",
            "telephone_number": "813-951-3002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6811 N CENTRAL AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336045500",
            "telephone_number": "813-951-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREECH",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-24",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW1196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZ",
            "last_name": "CREECH",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.