Individual provider Active NPI

Krystal Eve Gliva, LCSW, MCAP

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1740615723
Registry record updated Feb 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
24011 Issued in FL
Practice address
203 E Jean St
Tampa, FL 33604-6734
Phone
(813) 965-5566
NPI assigned
Sep 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2025

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 24011 FL Primary

Addresses

Primary practice location

203 E Jean St
Tampa, FL 33604-6734

Mailing address

203 E Jean St
Tampa, FL 33604-6734
Phone (813) 965-5566

Other practice location 1

1515 Michelin Ct
Lutz, FL 33549-7533
Phone (813) 949-8946 ext. 258

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Tampa Direct

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
I20250306001211 FL Practitioner - Clinical Social Worker 6103347182 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24011FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Feb 7, 2025 Accepting new patients
Sense the Possibilities, LLC PastSince Nov 1, 2020 Accepting new patients
University Medical Service Association Inc Past Accepting new patients

Locations

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 4

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": "1378684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739318400000",
    "number": "1740615723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E JEAN ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336046734",
            "telephone_number": "813-965-5566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E JEAN ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336046734",
            "telephone_number": "813-965-5566"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 Michelin Ct",
            "address_purpose": "LOCATION",
            "city": "Lutz",
            "state": "FL",
            "postal_code": "335497533",
            "country_code": "US",
            "telephone_number": "813-949-8946 x258",
            "fax_number": "813-949-2926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLIVA",
        "first_name": "KRYSTAL",
        "middle_name": "EVE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, MCAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-09",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "24011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Tampa",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6220 N Nebraska Ave",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336046257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.