Individual provider Active NPI

Ruth Leah Marcellino, LCSW

  • Clinical Social Worker
  • Palm Beach Gardens, FL
National Provider Identifier
1891520334
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7787 Issued in FL
Practice address
4590 Pga Blvd Ste 204
Palm Beach Gardens, FL 33418-3938
Phone
(561) 512-8049
NPI assigned
Sep 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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 7787 FL
Clinical Social Worker 1041C0700X SW7787 FL Primary

Addresses

Primary practice location

4590 Pga Blvd Ste 204
Palm Beach Gardens, FL 33418-3938

Mailing address

100 Wettaw LN Apt 30
North Palm Beach, FL 33408-5681
Phone (561) 512-8049

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
I20250102003752 FL Practitioner - Clinical Social Worker 2264969237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Amanda Patterson, LMHC, LLCGroup PAC ID 5193250207, 11 clinicians

Practice addresses (Care Compare)

4590 Pga Blvd
Suite 204
Palm Beach Gardens, FL 33418-3938
Phone (954) 378-5381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7787FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amanda Patterson, LMHC, LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

2929 N University Dr
Ste 205
Coral Springs, FL 33065
Phone (561) 408-1098

5400 S University Dr
Ste 308
Davie, FL 33328
Phone (978) 378-5381

4590 Pga Blvd
Ste 204
Palm Beach Gardens, FL 33418
Phone (561) 223-1066

2000 NW 150th Ave
#210
Pembroke Pines, FL 33028

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": "1725408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1891520334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WETTAW LN APT 30",
            "city": "NORTH PALM BEACH",
            "state": "FL",
            "postal_code": "334085681",
            "telephone_number": "561-512-8049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 PGA BLVD STE 204",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334183938",
            "telephone_number": "561-512-8049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCELLINO",
        "first_name": "RUTH",
        "middle_name": "LEAH",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-04",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "7787",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Beach Gardens, FL

Sources for this page

Verify at the official NPI Registry.