Individual provider Active NPI

Kathryn Florence Priest, LCSW

  • Clinical Social Worker
  • Port St Lucie, FL
National Provider Identifier
1770127938
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW14768 Issued in FL
Practice address
11987 SW Crestwood Cir
Port St Lucie, FL 34987-2739
Phone
(772) 577-8846
NPI assigned
Oct 31, 2019
Last updated
Jan 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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 SW14768 FL Primary

Addresses

Primary practice location

11987 SW Crestwood Cir
Port St Lucie, FL 34987-2739

Mailing address

145 NW Central Park PLZ Ste 102
Port St Lucie, FL 34986-2482
Phone (772) 218-5056

Other practice location 1

11987 SW Crestwood Cir
Port St Lucie, FL 34987-2739
Phone (772) 577-8846

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Symantec 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
I20200616000573 FL Practitioner - Clinical Social Worker 3072935329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

145 NW Central Park PLZ
Suite 102
Port Saint Lucie, FL 34986-2482

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW14768FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kate Priest LCSW LLC Clinical CurrentSince Jan 20, 2020 Accepting new patients
B&K Medical Supplies LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

145 NW Central Park Plz
Ste 102
Port St Lucie, FL 34986
Phone (772) 218-5056

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1572480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1770127938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 NW CENTRAL PARK PLZ STE 102",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349862482",
            "telephone_number": "772-218-5056",
            "fax_number": "561-210-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11987 SW CRESTWOOD CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349872739",
            "telephone_number": "772-577-8846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11987 SW Crestwood Cir",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349872739",
            "country_code": "US",
            "telephone_number": "772-577-8846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PRIEST",
        "first_name": "KATHRYN",
        "middle_name": "FLORENCE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-31",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Symantec",
            "affiliation": "N",
            "endpointDescription": "security software",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11987 SW Crestwood Cir",
            "city": "Port St Lucie",
            "state": "FL",
            "country_code": "US",
            "postal_code": "349872739",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.