Individual provider Active NPI

Victoria Kastor, LCSW

  • Clinical Social Worker
  • Bradenton, FL
National Provider Identifier
1790314318
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW17164 Issued in FL
Practice address
379 6TH Ave W
Bradenton, FL 34205-8820
Phone
(941) 782-4150
Fax
(941) 782-4104
NPI assigned
Apr 6, 2020
Last updated
Apr 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 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 SW17164 FL Primary

Addresses

Primary practice location

379 6TH Ave W
Bradenton, FL 34205-8820

Mailing address

PO Box 197515
Nashville, TN 37219-7515
Phone (941) 782-4391

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
I20220611000262 FL Practitioner - Clinical Social Worker 1254719784 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Florida, Inc. CurrentSince Jul 4, 2021 Accepting new patients
Centerstone of Florida, Inc. CurrentSince Mar 10, 2022 Accepting new patients

Locations

2020 26th Ave E
Bradenton, FL 34208
Phone (941) 782-4600

379 6th Ave W
Bradenton, FL 34205
Phone (941) 782-4100

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": "1586131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1790314318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197515",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372197515",
            "telephone_number": "941-782-4391",
            "fax_number": "941-782-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 6TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058820",
            "telephone_number": "941-782-4150",
            "fax_number": "941-782-4104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASTOR",
        "first_name": "VICTORIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-06",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW17164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.