Individual provider Active NPI

Letha Daisy Page, LCSW

  • Clinical Social Worker
  • Jacksonville, FL
National Provider Identifier
1922698604
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW18959 Issued in FL
Practice address
8647 Baypine Rd
Ste. 206
Jacksonville, FL 32256-7544
Phone
(904) 490-6974
Fax
(866) 489-5550
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 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 SW18959 FL Primary

Addresses

Primary practice location

8647 Baypine Rd
Ste. 206
Jacksonville, FL 32256-7544

Mailing address

12973 Chets Creek Dr S
Jacksonville, FL 32224-7485
Phone (904) 580-4535

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
I20220103000145 FL Practitioner - Clinical Social Worker 4688065501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8647 Baypine Rd
Suite 206
Jacksonville, FL 32256-7544
Phone (904) 580-4535

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW18959FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A New Page Counseling LLC Clinical CurrentSince Oct 11, 2021 Accepting new patients
Your Counseling Solutions. LLC PastSince Dec 17, 2023 Accepting new patients

Locations

8647 Baypine Rd
Ste 206
Jacksonville, FL 32256
Phone (904) 490-6974

4720 Salisbury Rd
Jacksonville, FL 32256
Phone (866) 932-2777

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": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1922698604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12973 CHETS CREEK DR S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322247485",
            "telephone_number": "904-580-4535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8647 BAYPINE RD",
            "address_2": "STE. 206",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567544",
            "telephone_number": "904-490-6974",
            "fax_number": "866-489-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "LETHA",
        "middle_name": "DAISY",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW18959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.