Individual provider Active NPI

Deborah Ann Whitehair, LCSW

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1922595578
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW7478 Issued in FL
Practice address
12550 New Brittany Blvd
Fort Myers, FL 33907-3655
Phone
(239) 343-9180
Fax
(239) 343-9188
NPI assigned
Apr 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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 SW7478 FL Primary

Addresses

Primary practice location

12550 New Brittany Blvd
Fort Myers, FL 33907-3655

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9180

Other identifiers 1

IdentifierTypeStateIssuer
100789200MedicaidFL

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

NPI Registry JSON

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

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1922595578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-9180",
            "fax_number": "239-343-9188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12550 NEW BRITTANY BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073655",
            "telephone_number": "239-343-9180",
            "fax_number": "239-343-9188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHAIR",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW7478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100789200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.