Individual provider Active NPI

Deborah Gellis, LCSW

  • Clinical Social Worker
  • West Palm Beach, FL
National Provider Identifier
1780615435
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12767 Issued in FL
Practice address
1825 Forest Hill Blvd Ste 103
West Palm Beach, FL 33406
Phone
(917) 838-3384
NPI assigned
Jul 5, 2006
Last updated
Jun 26, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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 071000-1 NY
Clinical Social Worker 1041C0700X SW12767 FL Primary

Addresses

Primary practice location

1825 Forest Hill Blvd Ste 103
West Palm Beach, FL 33406

Mailing address

PO Box 223211
West Palm Beach, FL 33422-3211
Phone (917) 838-3384

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
I20170320000346 FL Practitioner - Clinical Social Worker 0244213452 Practice locations: West Palm Beach, FL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1825 Forest Hill Blvd
Suite 103
West Palm Beach, FL 33406-6058
Phone (917) 838-3384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW12767FLMDClinical Social Worker
071000-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529971200000",
    "number": "1780615435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 223211",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334223211",
            "telephone_number": "917-838-3384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 FOREST HILL BLVD STE 103",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33406",
            "telephone_number": "917-838-3384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLIS",
        "first_name": "DEBORAH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-05",
        "last_updated": "2018-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071000-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.