Individual provider Active NPI

Alyssa K Hickey, LCSW

  • Clinical Social Worker
  • Stuart, FL
National Provider Identifier
1720575236
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17245 Issued in FL
Practice address
1111 SE Federal Hwy
Stuart, FL 34994-3840
Phone
(772) 220-0339
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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 SW17245 FL Primary

Addresses

Primary practice location

1111 SE Federal Hwy
Stuart, FL 34994-3840

Mailing address

1111 SE Federal Hwy Ste 206
Stuart, FL 34994-3842
Phone (772) 202-0339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jun 26, 2024 through Jun 26, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW17245FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Karen Moore, LCSW, LLC CurrentSince Jul 31, 2023 Accepting new patients

Locations

1111 SE Federal Hwy
Ste 206
Stuart, FL 34994
Phone (772) 212-2935

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1720575236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SE FEDERAL HWY STE 206",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943842",
            "telephone_number": "772-202-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SE FEDERAL HWY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943840",
            "telephone_number": "772-220-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKEY",
        "first_name": "ALYSSA",
        "middle_name": "K",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

Verify at the official NPI Registry.