Individual provider Active NPI

Phyllis Lavigna, LCSW

  • Clinical Social Worker
  • South Daytona, FL
National Provider Identifier
1740547686
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9461 Issued in FL
Practice address
1635 S Ridgewood Ave Ste 225
South Daytona, FL 32119-8478
Phone
(386) 788-5021
Fax
(386) 788-5021
NPI assigned
Apr 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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 SW9461 FL Primary

Addresses

Primary practice location

1635 S Ridgewood Ave Ste 225
South Daytona, FL 32119-8478

Mailing address

1635 S Ridgewood Ave Ste 225
South Daytona, FL 32119-8478
Phone (386) 788-5021

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
I20131205000650 FL Practitioner - Clinical Social Worker 3375770977 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Counseling and Disability ServicesGroup PAC ID 2769618040, 3 clinicians

Practice addresses (Care Compare)

1635 S Ridgewood Ave
Suite 225
South Daytona, FL 32119-8478
Phone (386) 788-5021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW9461FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling & Disability Services, LLC Clinical CurrentSince Oct 13, 2013 Accepting new patients

Locations

1635 S Ridgewood Ave
Ste 225
South Daytona, FL 32119
Phone (386) 788-5021

Networks

  • Freedom Health HMO Network

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": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1740547686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 S RIDGEWOOD AVE STE 225",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321198478",
            "telephone_number": "386-788-5021",
            "fax_number": "386-308-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 S RIDGEWOOD AVE STE 225",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321198478",
            "telephone_number": "386-788-5021",
            "fax_number": "386-788-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVIGNA",
        "first_name": "PHYLLIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

Verify at the official NPI Registry.