Fabray Dealow Smith-Wiggins, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW22559 Issued in FL

Practice address

124 NW Madison St
Lake City, FL 32055-3922

Phone

(386) 209-0619

NPI assigned

Sep 30, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Fabray Wiggins Other name

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932
  Medicare reassignment NPD
• Paraclete Counseling & Case Management of Florida LLC

  • Clinical Social Worker
  • Lake City, FL
  • NPI 1508623166
  NPD Authorized official

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1821425372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 NW LAKE JEFFERY RD",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554773",
            "telephone_number": "386-209-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NW MADISON ST",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320553922",
            "telephone_number": "386-209-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-WIGGINS",
        "first_name": "FABRAY",
        "middle_name": "DEALOW",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FABRAY",
            "last_name": "WIGGINS",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Chasidy Dionne Singleton, M.D.
• Supachoke - Sirisuwanangkura, MD
• Benjamin M Sloan
• Smile Designs by Charlotte Gerry
• Smile Designs by Dr. Charlotte Gerry
• Ayanna Smith, LMT
• Bethany Grace Smith
• Danielle Smith, OTR/L
• Jessica Lynn Smith
• Maria D. Smith, M.D.

• Clinical Social Worker in Lake City, FL
• Providers in Lake City, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.