Individual provider Active NPI

Davia Angelique Lerebours, LCSW

  • Clinical Social Worker
  • Clearwater, FL
National Provider Identifier
1770857070
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW8582 Issued in FL
Practice address
28471 US Highway 19 N Ste 514
Clearwater, FL 33761-4340
Phone
(727) 479-6041
NPI assigned
Mar 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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 SW8582 FL Primary

Addresses

Primary practice location

28471 US Highway 19 N Ste 514
Clearwater, FL 33761-4340

Mailing address

28471 US Highway 19 N Ste 514
Clearwater, FL 33761-4340
Phone (727) 479-6041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW8582FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sara G Graff L C S W P a Clinical CurrentSince Mar 6, 2012 Accepting new patients

Locations

1497 Main St
Dunedin, FL 34698
Phone (727) 479-6041

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": "1330819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334707200000",
    "number": "1770857070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28471 US HIGHWAY 19 N STE 514",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337614340",
            "telephone_number": "727-479-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28471 US HIGHWAY 19 N STE 514",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337614340",
            "telephone_number": "727-479-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEREBOURS",
        "first_name": "DAVIA",
        "middle_name": "ANGELIQUE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-04",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.