Individual provider Active NPI

Larenda Ann Duley, LCSW

  • Clinical Social Worker
  • Melbourne, FL
National Provider Identifier
1861500647
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7217 Issued in FL
Practice address
1425 Aurora Rd
Melbourne, FL 32935-5384
Phone
(321) 242-3110
Fax
(321) 242-7464
NPI assigned
Aug 29, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW7217 FL Primary
Clinical Social Worker 1041C0700X LCSW3134 HI

Addresses

Primary practice location

1425 Aurora Rd
Melbourne, FL 32935-5384

Mailing address

5440 Willoughby Dr
Melbourne, FL 32934-2819
Phone (321) 720-1513

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW7217FLMDClinical Social Worker
LCSW3134HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Paula Deforest PHD LLC Past Accepting new patients
South Brevard Women's Center, Inc Past Accepting new patients

Organizations & group practices 2

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861500647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 WILLOUGHBY DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329342819",
            "telephone_number": "321-720-1513",
            "fax_number": "321-253-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 AURORA RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329355384",
            "telephone_number": "321-242-3110",
            "fax_number": "321-242-7464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DULEY",
        "first_name": "LARENDA",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7217",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW3134",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.