Individual provider Active NPI

Deshisha R. Holton, LCSW

  • Clinical Social Worker
  • Lakeland, FL
National Provider Identifier
1770810764
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 7756 Issued in FL
Practice address
PO Box 24722
Lakeland, FL 33802-4722
Phone
(813) 402-8780
NPI assigned
Nov 11, 2009
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LICSW126772 MA
Clinical Social Worker 1041C0700X SW 7756 FL Primary

Addresses

Primary practice location

PO Box 24722
Lakeland, FL 33802-4722

Mailing address

PO Box 24722
Lakeland, FL 33802-4722
Phone (813) 402-8780

Other names 1

  • Ms. Dee R. Holton Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100819000106 FL Practitioner - Clinical Social Worker 8123152675 Reassigns benefits to 1 organization
I20250909004161 MA Practitioner - Clinical Social Worker 8123152675 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11510 Brighton Knoll Loop
Riverview, FL 33579-2123

13000 Bruce B Downs Blvd
Tampa, FL 33612-4745

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 7756FLMDClinical Social Worker
LICSW126772MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Mar 26, 2025 Accepting new patients

Locations

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

101 Federal St
Boston, MA 02110
Phone (206) 744-8030

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, 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": "1257897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1770810764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24722",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338024722",
            "telephone_number": "813-402-8780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 24722",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338024722",
            "telephone_number": "813-402-8780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTON",
        "first_name": "DESHISHA",
        "middle_name": "R.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-11",
        "last_updated": "2024-08-09",
        "certification_date": "2024-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW126772",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 7756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEE",
            "last_name": "HOLTON",
            "middle_name": "R.",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.