Active NPI
Mildre O Ceballos, LCSW
- Clinical Social Worker
- Miami, FL
National Provider Identifier
1821217779
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW 9296
- Practice address
- 10300 SW 216TH St
Miami, FL 33190-1003 - Phone
- (305) 253-5100
- NPI assigned
- Apr 25, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW 9296 | FL | Primary |
Addresses
Primary practice location
10300 SW 216TH St
Miami, FL 33190-1003
Mailing address
10300 SW 216TH St
Miami, FL 33190-1003
Phone (305) 815-1441
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SW 9296 | Other | FL | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| SW 9296 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1280880000000",
"number": "1821217779",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10300 SW 216TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331901003",
"telephone_number": "305-815-1441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10300 SW 216TH ST",
"city": "MIAMI",
"state": "FL",
"postal_code": "331901003",
"telephone_number": "305-253-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CEBALLOS",
"first_name": "MILDRE",
"middle_name": "O",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-25",
"last_updated": "2010-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW 9296",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "SW 9296",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.