Individual provider Active NPI

Patricia A Richeson, LCSW

  • Clinical Social Worker
  • Deland, FL
National Provider Identifier
1891269247
Registry record updated Apr 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13613 Issued in FL
Practice address
333 W Wisconsin Ave
Deland, FL 32720-4132
Phone
(386) 734-3101
NPI assigned
Jan 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2020

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 SW13613 FL Primary

Addresses

Primary practice location

333 W Wisconsin Ave
Deland, FL 32720-4132

Mailing address

721 W Minnesota Ave
Deland, FL 32720-3201
Phone (781) 640-1654

Other practice location 1

721 W Minnesota Ave
Deland, FL 32720-3201
Phone (781) 640-1654

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
I20190612003229 FL Practitioner - Clinical Social Worker 9234462854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

721 W Minnesota Ave
Deland, FL 32720-3201
Phone (781) 640-1654

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW13613FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Biopsychosocial Counseling, LLC CurrentSince Jun 1, 2019 Accepting new patients

Locations

333 W Wisconsin Ave
Deland, FL 32720
Phone (386) 337-4308

Organizations & group practices 1

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": "1547769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586131200000",
    "number": "1891269247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 W MINNESOTA AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327203201",
            "telephone_number": "781-640-1654",
            "fax_number": "386-279-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W WISCONSIN AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327204132",
            "telephone_number": "386-734-3101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 W Minnesota Ave",
            "address_purpose": "LOCATION",
            "city": "Deland",
            "state": "FL",
            "postal_code": "327203201",
            "country_code": "US",
            "telephone_number": "781-640-1654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICHESON",
        "first_name": "PATRICIA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-18",
        "last_updated": "2020-04-06",
        "certification_date": "2020-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.