Individual provider Active NPI

Kristy Sporrer, LCSW

  • Clinical Social Worker
  • Palmetto Bay, FL
National Provider Identifier
1750140794
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22775 Issued in FL
Practice address
7300 SW 148TH St
Palmetto Bay, FL 33158-2126
Phone
(305) 999-5177
NPI assigned
Mar 13, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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 22775 FL Primary

Addresses

Primary practice location

7300 SW 148TH St
Palmetto Bay, FL 33158-2126

Mailing address

7300 SW 148TH St
Palmetto Bay, FL 33158-2126
Phone (305) 999-5177

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
I20241119004095 FL Practitioner - Clinical Social Worker 7012442627 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Palmetto Bay, FL 33158
Phone (305) 999-5177

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22775FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KLS Counseling, LLC Clinical CurrentSince Aug 21, 2024 Accepting new patients

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": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1750140794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 SW 148TH ST",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331582126",
            "telephone_number": "305-999-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 SW 148TH ST",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331582126",
            "telephone_number": "305-999-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPORRER",
        "first_name": "KRISTY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "22775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmetto Bay, FL

Sources for this page

Verify at the official NPI Registry.