Individual provider Active NPI

Waleska Acevedo, LCSW

  • Clinical Social Worker
  • Bradenton, FL
National Provider Identifier
1871858175
Registry record updated Mar 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW12095 Issued in FL
Practice address
379 6TH Ave W
Bradenton, FL 34205-8820
Phone
(941) 782-4100
Fax
(941) 782-4101
NPI assigned
Jul 12, 2012
Last updated
Mar 9, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW12095 FL Primary

Addresses

Primary practice location

379 6TH Ave W
Bradenton, FL 34205-8820

Mailing address

PO Box 197515
Nashville, TN 37219-7515
Phone (941) 782-4299

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
I20140929002493 FL Practitioner - Clinical Social Worker 0840410635 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerstone of Florida IncGroup PAC ID 2668468596, 35 clinicians
Betterment Mental Health Counseling, Inc.Group PAC ID 6709249642, 8 clinicians

Practice addresses (Care Compare)

379 6TH Ave W
Bradenton, FL 34205-8820
Phone (941) 782-4150

4242 S Tamiami TRL
Venice, FL 34293-5105
Phone 9418004924101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Florida, Inc. CurrentSince Mar 13, 2022 Accepting new patients
Betterment Mental Health Counseling, Inc. CurrentSince Oct 1, 2023 Accepting new patients

Locations

1303 10th St E
Ste A
Palmetto, FL 34221
Phone (941) 800-4924

4242 S Tamiami Trl
Venice, FL 34293
Phone (941) 800-4924

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1871858175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197515",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372197515",
            "telephone_number": "941-782-4299",
            "fax_number": "941-782-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 6TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058820",
            "telephone_number": "941-782-4100",
            "fax_number": "941-782-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACEVEDO",
        "first_name": "WALESKA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-12",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.