Elbydia Souverain, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW21106 Issued in FL

Practice address

11055 SW 186TH St Ste 207
Cutler Bay, FL 33157-6842

Phone

(786) 692-5743

Fax

(786) 422-9043

NPI assigned

Feb 12, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elbydia Souverian Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1902660681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11055 SW 186TH ST STE 207",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576842",
            "telephone_number": "786-692-5743",
            "fax_number": "786-422-9043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11055 SW 186TH ST STE 207",
            "city": "CUTLER BAY",
            "state": "FL",
            "postal_code": "331576842",
            "telephone_number": "786-692-5743",
            "fax_number": "786-422-9043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUVERAIN",
        "first_name": "ELBYDIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21106",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "SW21106",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELBYDIA",
            "last_name": "SOUVERIAN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Clinical Social Worker in Cutler Bay, FL
• Providers in Cutler Bay, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.