Individual provider Active NPI

Angela Dawn Lancaster, LCSW

  • Clinical Social Worker
  • Largo, FL
National Provider Identifier
1720244593
Registry record updated Apr 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
15977 Issued in FL
Practice address
3900 Belle Oak Blvd Ste 106
Largo, FL 33771-2758
Phone
(727) 203-5011
NPI assigned
Jul 31, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X 15977 FL Primary
Social Worker 104100000X 24059 CA
Clinical Social Worker 1041C0700X 28459 CA
Clinical Social Worker 1041C0700X 6461 TN

Addresses

Primary practice location

3900 Belle Oak Blvd Ste 106
Largo, FL 33771-2758

Mailing address

3900 Belle Oak Blvd Ste 106
Largo, FL 33771-2758
Phone (727) 203-5011

Other practice location 1

9445 Farnham St Ste 100
San Diego, CA 92123-1308
Phone (858) 380-4676

Other practice location 2

9445 Farnham St Ste 100
San Diego, CA 92123-1308
Phone (858) 380-4676

Other practice location 3

601 Benton Ave
Nashville, TN 37204-2303
Phone (615) 292-9770

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2026 through Jul 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15977FLMDClinical Social Worker
6461TNMDPhysical Therapy Assistant
24059CAMDOccupational Therapist
28459CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1720244593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 BELLE OAK BLVD STE 106",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712758",
            "telephone_number": "727-203-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 BELLE OAK BLVD STE 106",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337712758",
            "telephone_number": "727-203-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9445 Farnham St Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231308",
            "country_code": "US",
            "telephone_number": "858-380-4676",
            "fax_number": "858-569-1873",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9445 Farnham St Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921231308",
            "country_code": "US",
            "telephone_number": "858-380-4676",
            "fax_number": "858-569-1873",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 Benton Ave",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372042303",
            "country_code": "US",
            "telephone_number": "615-292-9770",
            "fax_number": "615-385-1842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANCASTER",
        "first_name": "ANGELA",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "15977",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "24059",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28459",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "6461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

Verify at the official NPI Registry.