Individual provider Active NPI

Jessica Velazquez, LCSW

  • Clinical Social Worker
  • Pembroke Pines, FL
National Provider Identifier
1871248864
Registry record updated Jun 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW18988 Issued in FL
Practice address
620 Cypress Pointe Dr W
Pembroke Pines, FL 33027-1362
Phone
(786) 523-2453
NPI assigned
Feb 17, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 8, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X SW18988 FL
Clinical Social Worker 1041C0700X SW18988 FL Primary
Mental Health Counselor 101YM0800X SW18988 FL

Addresses

Primary practice location

620 Cypress Pointe Dr W
Pembroke Pines, FL 33027-1362

Mailing address

620 Cypress Pointe Dr W
Pembroke Pines, FL 33027-1362
Phone (786) 523-2453

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
I20250627000441 FL Practitioner - Clinical Social Worker 5597278267 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW18988FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Golden Age Mental Health LLC Behavior Analyst CurrentSince Jun 6, 2025 Accepting new patients
Elevate Life, LLC Clinical CurrentSince Sep 21, 2025 Accepting new patients

Locations

1490 NE Pine Island Rd
Ste 6C
Cape Coral, FL 33909
Phone (239) 203-1248

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780876800000",
    "number": "1871248864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 CYPRESS POINTE DR W",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271362",
            "telephone_number": "786-523-2453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CYPRESS POINTE DR W",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330271362",
            "telephone_number": "786-523-2453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2026-06-08",
        "certification_date": "2026-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "SW18988",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18988",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW18988",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

Verify at the official NPI Registry.