Individual provider Active NPI

Heidi Chinlund, MSW

  • Clinical Social Worker
  • Lakeland, FL
National Provider Identifier
1902230683
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 13348 Issued in FL
Practice address
4415 Florida National Dr Ste 214
Lakeland, FL 33813-1573
Phone
(407) 625-0808
NPI assigned
Aug 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X SW 13348 FL Primary

Addresses

Primary practice location

4415 Florida National Dr Ste 214
Lakeland, FL 33813-1573

Mailing address

PO Box 26
Intercession City, FL 33848-0026
Phone (407) 625-0808

Other practice location 1

2515 Old Kent circle
Kissimmee, FL 34758
Phone (407) 625-0808

Other identifiers 1

IdentifierTypeStateIssuer
010940500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 13348FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Purple Cactus Counseling LLC Clinical Current Accepting new patients

Locations

4415 Florida National Dr
Ste 214
Lakeland, FL 33813
Phone (407) 625-0808

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": "1377734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1902230683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "INTERCESSION CITY",
            "state": "FL",
            "postal_code": "338480026",
            "telephone_number": "407-625-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 FLORIDA NATIONAL DR STE 214",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338131573",
            "telephone_number": "407-625-0808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2515 Old Kent circle",
            "address_purpose": "LOCATION",
            "city": "Kissimmee",
            "state": "FL",
            "postal_code": "34758",
            "country_code": "US",
            "telephone_number": "407-625-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHINLUND",
        "first_name": "HEIDI",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 13348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010940500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.