Erica Ann Justavino, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW18159 Issued in FL

Practice address

2864 Moody Ave
Orange Park, FL 32073-6423

Phone

(352) 478-8395

NPI assigned

Feb 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Erica Ann Ward Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620777600000",
    "number": "1770040875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2864 MOODY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320736423",
            "telephone_number": "352-478-8395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2864 MOODY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320736423",
            "telephone_number": "352-478-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTAVINO",
        "first_name": "ERICA",
        "middle_name": "ANN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERICA",
            "last_name": "WARD",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Guerlande V Joseph, LMHC
• Suhas Vishnu Joshi, M.D.
• Jsa Consultants LLC
• Hannah Judd, M.S., CCC-SLP
• Cameron Juneau
• Jennifer Amanda Justice, DPT, SCS
• James Emmett Kaelin, M.D.
• Silvia Kaelin
• Josephine Kaidy, DPT
• Beth E. Kailes, DMD

• Clinical Social Worker in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.