Active NPI
Malissa Maki
- Clinical Social Worker
- Cape Coral, FL
National Provider Identifier
1851766471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 204514269
- Practice address
- 3723A Delprado Blvd
Cape Coral, FL 33904 - Phone
- (239) 540-1155
- NPI assigned
- Dec 8, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 204514269 | FL | Primary |
Addresses
Primary practice location
3723A Delprado Blvd
Cape Coral, FL 33904
Mailing address
3723 Delprado Blvd
Cape Coral, FL 33904
Phone (239) 540-1155
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001629900 | Medicaid | FL |
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 |
|---|---|---|---|
| 204514269 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449532800000",
"number": "1851766471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3723 DELPRADO BLVD",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "33904",
"telephone_number": "239-540-1155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3723A DELPRADO BLVD",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "33904",
"telephone_number": "239-540-1155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAKI",
"first_name": "MALISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-08",
"last_updated": "2015-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "204514269",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "001629900",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.