Individual provider Active NPI

Lauren A Deblasio, MSW, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1912683178
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13459 Issued in FL
Practice address
4651 Salisbury Rd
Jacksonville, FL 32256-6107
Phone
(646) 453-6777
Fax
(212) 337-9841
NPI assigned
Jun 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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 SW13459 FL Primary

Addresses

Primary practice location

4651 Salisbury Rd
Jacksonville, FL 32256-6107

Mailing address

PO Box 542234
Lake Worth, FL 33454-2234
Phone (810) 210-2738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW13459FLMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1687478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1912683178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 542234",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334542234",
            "telephone_number": "810-210-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 SALISBURY RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566107",
            "telephone_number": "646-453-6777",
            "fax_number": "212-337-9841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBLASIO",
        "first_name": "LAUREN",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-23",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.