Individual provider Active NPI

Jennifer Fuentes Robison, LCSW, MSW

  • Clinical Social Worker
  • Brandon, FL
National Provider Identifier
1821565177
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW23297 Issued in FL
Practice address
109 N Oakwood Ave Ste 105
Brandon, FL 33510-4629
Phone
(813) 355-0878
NPI assigned
Oct 25, 2018
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X ISW16298 FL
Clinical Social Worker 1041C0700X SW23297 FL Primary

Addresses

Primary practice location

109 N Oakwood Ave Ste 105
Brandon, FL 33510-4629

Mailing address

109 N Oakwood Ave Ste 105
Brandon, FL 33510-4629
Phone (813) 355-0878

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
I20241115002471 FL Practitioner - Clinical Social Worker 6305370180 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW16298FLMDSocial Worker
SW23297FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tranquility Wellness Group, LLC Clinical CurrentSince Sep 8, 2024 Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Nov 8, 2024 Accepting new patients
Emerald Clover, LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

109 N Oakwood Ave
Ste 105
Brandon, FL 33510
Phone (813) 819-8704

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 3

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": "1540425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1821565177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 N OAKWOOD AVE STE 105",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104629",
            "telephone_number": "813-355-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 N OAKWOOD AVE STE 105",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104629",
            "telephone_number": "813-355-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBISON",
        "first_name": "JENNIFER",
        "middle_name": "FUENTES",
        "credential": "LCSW, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-25",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "ISW16298",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW23297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.