Estafan N.S. Farag, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW 5839 Issued in FL

Practice address

2180 W 1St St
Suite 202
Fort Myers, FL 33901-3222

Phone

(239) 332-8009

Fax

(239) 332-8009

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MCR Health IncGroup PAC ID 7214847995, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: estafan.farag.1@11352.direct.athenahealth.com

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.

• MCR Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Parrish, FL
  • NPI 1255376000
  Medicare reassignment Care Compare group NPD
• MCR Health, Inc.

  • Non-Pharmacy Dispensing Site
  • Bradenton, FL
  • NPI 1821878745
  NPD
• JBH Behavioral Health Systems LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1659545978
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1740320050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 W 1ST ST",
            "address_2": "SUITE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339013222",
            "telephone_number": "239-332-8009",
            "fax_number": "239-332-8009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 W 1ST ST",
            "address_2": "SUITE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339013222",
            "telephone_number": "239-332-8009",
            "fax_number": "239-332-8009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave Bldg B",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668752",
            "country_code": "US",
            "telephone_number": "863-494-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARAG",
        "first_name": "ESTAFAN",
        "middle_name": "N.S.",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW5839",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 5839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "764547300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Preservation Services
• Family Preservation Services
• Family Psychiatry, Inc.
• Family Tree Agency LLC
• Family Universal Medical Center, LLC
• John Farag, D.O.
• Sherry Farag, M.D.
• Farah Family Health Center Inc
• Jason P Farah, APRN
• Farahmand Plastic Surgery P.L.

• Clinical Social Worker in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.