Individual provider Active NPI

Stephanie D Avinger, LCSW-C, LCSW, LICSW

  • Clinical Social Worker
  • Ponte Vedra, FL
National Provider Identifier
1962821884
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW23132 Issued in FL
Practice address
466 Town Plaza Ave Ste 310
Ponte Vedra, FL 32081-5185
Phone
(443) 581-8200
NPI assigned
Apr 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149027336 IL
Clinical Social Worker 1041C0700X SW23132 FL Primary
Clinical Social Worker 1041C0700X 19606 MD
Clinical Social Worker 1041C0700X LC50082946 DC

Addresses

Primary practice location

466 Town Plaza Ave Ste 310
Ponte Vedra, FL 32081-5185

Mailing address

4450 Tropea Way Unit 1431
Jacksonville, FL 32246-8885
Phone (267) 235-4263

Other identifiers 2

IdentifierTypeStateIssuer
BK70-0000OtherMDCAREFIRST BCBS
079653100MedicaidMD

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
I20251106005010 FL Practitioner - Clinical Social Worker 1254646680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1 Optum Cir
Eden Prairie, MN 55344-2956

6320 Venture Dr
Suite 203
Lakewood Ranch, FL 34202-5130

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50082946DCMDClinical Social Worker
SW23132FLMDClinical Social Worker
149027336ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, P.C. Clinical CurrentSince Aug 23, 2025 Accepting new patients
Optum Behavioral Care of North Carolina, PC Current Accepting new patients
Optum Behavioral Care of North Carolina, P.C. Clinical CurrentSince Aug 23, 2025 Accepting new patients
SD Avinger Consulting Services LLC Clinical Past Accepting new patients

Locations

466 Town Plaza Ave
Ste 310
Ponte Vedra, FL 32081
Phone (443) 581-8200

1090 Tamiami Trl
Sarasota, FL 34236
Phone 94136308782005

Organizations & group practices 4

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": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1962821884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4450 TROPEA WAY UNIT 1431",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322468885",
            "telephone_number": "267-235-4263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 TOWN PLAZA AVE STE 310",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320815185",
            "telephone_number": "443-581-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVINGER",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "credential": "LCSW-C, LCSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149027336",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW23132",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "19606",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DC",
            "license": "LC50082946",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "BK70-0000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079653100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

Verify at the official NPI Registry.