Individual provider Active NPI

Patrina May Lawrence, MSW

  • Clinical Social Worker
  • Kissimmee, FL
National Provider Identifier
1962635938
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 9612 Issued in FL
Practice address
510 Peace Dr
Kissimmee, FL 34759-5432
Phone
(863) 496-1239
Fax
(863) 496-1239
NPI assigned
Aug 25, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC50078163 DC
Clinical Social Worker 1041C0700X SW 9612 FL Primary

Addresses

Primary practice location

510 Peace Dr
Kissimmee, FL 34759-5432

Mailing address

510 Peace Dr
Kissimmee, FL 34759-5432
Phone (863) 496-5151

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
LC50078163DCMDClinical Social Worker
SW 9612FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serving Children and Reaching Families Current Accepting new patients

Organizations & group practices 1

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": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390348800000",
    "number": "1962635938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 PEACE DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347595432",
            "telephone_number": "863-496-5151",
            "fax_number": "863-496-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 PEACE DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347595432",
            "telephone_number": "863-496-1239",
            "fax_number": "863-496-1239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "PATRINA",
        "middle_name": "MAY",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2014-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50078163",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 9612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.