Individual provider Active NPI

Reginald Vilmenay, LCSW

  • Clinical Social Worker
  • Brandon, FL
National Provider Identifier
1740455344
Registry record updated May 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 8425 Issued in FL
Practice address
220 W Brandon Blvd
Suite 203
Brandon, FL 33511-5104
Phone
(813) 892-6203
Fax
(813) 381-3909
NPI assigned
Apr 24, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2013

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 SW 8425 FL Primary

Addresses

Primary practice location

220 W Brandon Blvd
Suite 203
Brandon, FL 33511-5104

Mailing address

220 W Brandon Blvd
Suite 203
Brandon, FL 33511-5104
Phone (813) 892-6203

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
I20140220000800 FL Practitioner - Clinical Social Worker 3971733809 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 8425FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Therapy Empowering People, PLLC Clinical CurrentSince Jan 8, 2014 Accepting new patients

Locations

220 W Brandon Blvd
Ste 203
Brandon, FL 33511
Phone (813) 382-3377

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367366400000",
    "number": "1740455344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 W BRANDON BLVD",
            "address_2": "SUITE 203",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115104",
            "telephone_number": "813-892-6203",
            "fax_number": "813-381-3909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W BRANDON BLVD",
            "address_2": "SUITE 203",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115104",
            "telephone_number": "813-892-6203",
            "fax_number": "813-381-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILMENAY",
        "first_name": "REGINALD",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-24",
        "last_updated": "2013-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 8425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.