Individual provider Active NPI

Eileen Robertson, REGISTERED CLINICAL

  • Clinical Social Worker
  • Venice, FL
National Provider Identifier
1730782178
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17958 Issued in FL
Practice address
333 Tamiami TRL S Ste 301
Venice, FL 34285-2428
Phone
(941) 500-9796
NPI assigned
Nov 18, 2020
Last updated
Dec 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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 SW17958 FL Primary

Addresses

Primary practice location

333 Tamiami TRL S Ste 301
Venice, FL 34285-2428

Mailing address

6368 Sunnybrook Blvd Apt a
Englewood, FL 34224-8458
Phone (941) 208-5363

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
I20201229000258 FL Practitioner - Clinical Social Worker 3173936713 Reassigns benefits to 1 organization
Practice locations: Venice, FL; Englewood, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Betterment Mental Health Counseling, Inc.Group PAC ID 6709249642, 8 clinicians

Practice addresses (Care Compare)

4242 S Tamiami TRL
Venice, FL 34293-5105
Phone 9418004924101

Merit-based Incentive Payment System (MIPS)

Final score
87.43 of 100Reported as group
Quality
74.02
Promoting interoperability
100
Improvement activities
40
Cost
77.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW17958FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Betterment Mental Health Counseling, Inc. CurrentSince Feb 28, 2024 Accepting new patients

Locations

4242 S Tamiami Trl
Venice, FL 34293
Phone (941) 800-4924

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1730782178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6368 SUNNYBROOK BLVD APT A",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342248458",
            "telephone_number": "941-208-5363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 TAMIAMI TRL S STE 301",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852428",
            "telephone_number": "941-500-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "EILEEN",
        "credential": "REGISTERED CLINICAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

Verify at the official NPI Registry.