Individual provider Active NPI

Alexandria Novytskyi, LCSW

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1902472384
Registry record updated Oct 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW22442 Issued in FL
Practice address
3645 Schoolhouse Rd W Unit 205
Fort Myers, FL 33916-8198
Phone
(954) 636-0741
NPI assigned
May 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2024

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 SW22442 FL Primary

Addresses

Primary practice location

3645 Schoolhouse Rd W Unit 205
Fort Myers, FL 33916-8198

Mailing address

2100 NW 76TH Ave
Margate, FL 33063-7960
Phone (954) 636-0741

Other practice location 1

2100 NW 76th Ave
Margate, FL 33063-7960
Phone (954) 636-0741

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
I20241113004334 FL Practitioner - Clinical Social Worker 1355875360 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mentus Behavioral Health LLCGroup PAC ID 0143602110, 5 clinicians
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

12651 McGregor Blvd
Suite 301
Fort Myers, FL 33919-4488
Phone (239) 314-3223

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW22442FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Oct 11, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

Organizations & group practices 2

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": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1902472384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 NW 76TH AVE",
            "city": "MARGATE",
            "state": "FL",
            "postal_code": "330637960",
            "telephone_number": "954-636-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3645 SCHOOLHOUSE RD W UNIT 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339168198",
            "telephone_number": "954-636-0741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 NW 76th Ave",
            "address_purpose": "LOCATION",
            "city": "Margate",
            "state": "FL",
            "postal_code": "330637960",
            "country_code": "US",
            "telephone_number": "954-636-0741",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOVYTSKYI",
        "first_name": "ALEXANDRIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.