Individual provider Active NPI

Stephanie Grace Haffield, LCSW

  • Clinical Social Worker
  • Riviera Beach, FL
National Provider Identifier
1750762530
Registry record updated Aug 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW-12400 Issued in FL
Practice address
2001 W Blue Heron Blvd
Riviera Beach, FL 33404-5003
Phone
(561) 841-3500
NPI assigned
Jun 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X SW12400 FL
Clinical Social Worker 1041C0700X SW-12400 FL Primary

Addresses

Primary practice location

2001 W Blue Heron Blvd
Riviera Beach, FL 33404-5003

Mailing address

506 SE Kyle Rd
Port St Lucie, FL 34984-6237
Phone (772) 486-5143

Other practice location 1

725 N 12th Ave # Buildigb
Arcadia, FL 34266-8752
Phone (863) 494-1242

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
I20160418001981 FL Practitioner - Clinical Social Worker 6901104348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Balanced Wellbeing LLCGroup PAC ID 5193021848, 228 clinicians
MCR Health IncGroup PAC ID 7214847995, 132 clinicians

Practice addresses (Care Compare)

3200 SW 34TH Ave
Suite 701
Ocala, FL 34474-8443
Phone (877) 779-2429

725 N 12TH Ave
B
Arcadia, FL 34266-8752
Phone (863) 494-1242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW-12400FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ultima Rehab-FL LLC CurrentSince May 29, 2019 Accepting new patients

Locations

390 Pondella Rd
Ste 9
North Ft Myers, FL 33903
Phone (239) 652-0260

Networks

  • Freedom Health HMO Network

Organizations & group practices 3

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": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629936000000",
    "number": "1750762530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 SE KYLE RD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349846237",
            "telephone_number": "772-486-5143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W BLUE HERON BLVD",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334045003",
            "telephone_number": "561-841-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave # Buildigb",
            "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": "HAFFIELD",
        "first_name": "STEPHANIE",
        "middle_name": "GRACE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-17",
        "last_updated": "2021-08-26",
        "certification_date": "2021-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW12400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW-12400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

Verify at the official NPI Registry.