Active NPI
Natalya V Gaydarzhi, LICSW
- Clinical Social Worker
- Lake City, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60301275
- Practice address
- 619 S Marion Ave
Lake City, FL 32025-5808 - Phone
- (904) 470-6900
- NPI assigned
- Jan 10, 2014
- Last updated
- Jul 29, 2022
- 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 | LW60301275 | WA | Primary |
Addresses
Primary practice location
619 S Marion Ave
Lake City, FL 32025-5808
Mailing address
619 S Marion Ave
Lake City, FL 32025-5808
Phone (904) 470-6900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1455 NW Leary Way
Suite 400
Seattle, WA 98107-5138
Phone (206) 202-8506
66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW60301275 | WA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Clinical | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506
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": "1389312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659052800000",
"number": "1821410721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "619 S MARION AVE",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320255808",
"telephone_number": "904-470-6900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "619 S MARION AVE",
"city": "LAKE CITY",
"state": "FL",
"postal_code": "320255808",
"telephone_number": "904-470-6900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYDARZHI",
"first_name": "NATALYA",
"middle_name": "V",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-01-10",
"last_updated": "2022-07-29",
"certification_date": "2022-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60301275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.