Individual provider Active NPI

Marsha Kelly Oxamendi, LCSW

  • Clinical Social Worker
  • Perry, FL
National Provider Identifier
1891223970
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11952 Issued in FL
Practice address
555 N Byron Butler Pkwy
Perry, FL 32347-2315
Phone
(850) 329-5776
Fax
(888) 974-6195
NPI assigned
Jun 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 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 SW11952 FL Primary

Addresses

Primary practice location

555 N Byron Butler Pkwy
Perry, FL 32347-2315

Mailing address

1293 Cordova Cir
Tallahassee, FL 32317-8480
Phone (850) 556-4797

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
I20171009002515 FL Practitioner - Clinical Social Worker 8921373465 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
A New Dawn, a New Beginning, IncGroup PAC ID 7618380601, 5 clinicians
Beth Davalos Counseling Center LLCGroup PAC ID 3375978414, 32 clinicians

Practice addresses (Care Compare)

1706 S Jefferson St
Perry, FL 32348-5611
Phone (850) 329-5776

540 E Horatio Ave
Suite 200
Maitland, FL 32751-7314
Phone (407) 401-9020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW11952FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Davalos Counseling Center LLC Clinical CurrentSince Sep 18, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince Aug 1, 2025 Accepting new patients

Locations

2328 10th Ave N
Ste 201
Lake Worth, FL 33461
Phone (561) 236-7622

540 E Horatio Ave
Ste 200
Maitland, FL 32751
Phone (407) 401-9020

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": "1496275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1891223970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1293 CORDOVA CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323178480",
            "telephone_number": "850-556-4797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N BYRON BUTLER PKWY",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472315",
            "telephone_number": "850-329-5776",
            "fax_number": "888-974-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OXAMENDI",
        "first_name": "MARSHA",
        "middle_name": "KELLY",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, FL

Sources for this page

Verify at the official NPI Registry.