BRIAN SHEA LCSW
NPI 1023628807
Social Worker - Clinical in Port Orange, FL
NPI Status: Active since August 05, 2020
Contact Information
740 DUNLAWTON AVE
PORT ORANGE, FL
ZIP 32127
Phone: (386) 763-1000
- Individual
- Male
- Social Worker
- Clinical
- Accepts Insurance
- PECOS Enrolled
About BRIAN SHEA
This page provides the complete NPI Profile along with additional information for Brian Shea, a provider established in Port Orange, Florida with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1023628807 assigned on August 2020. The practitioner's primary taxonomy code is 1041C0700X with license number SW13450 (FL). The provider is registered as an individual and his NPI record was last updated one year ago.
- NPI
- 1023628807
- Provider Name
- BRIAN SHEA LCSW
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 740 DUNLAWTON AVE PORT ORANGE, FL 32127
- Location Phone
- (386) 763-1000
- Mailing Address
- 740 DUNLAWTON AVE PORT ORANGE, FL 32127
- Mailing Phone
- (386) 763-1000
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 08-05-2020
- Last Update Date
- 05-05-2025
- Code Navigator
A clinical social worker like Brian Shea is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- SW13450
- License State
- FL
- Taxonomy Description
- A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gym Access IND Bronze HMO 1340 - HMO
- Gym Access IND Bronze HMO OA 1211 - HMO
- Gym Access IND Bronze HMO OA Standard 2450 - HMO
- Gym Access IND Bronze POS 1042 - POS
- Gym Access IND Bronze POS BC 3841 - POS
- Gym Access IND Bronze POS OA 1211 - POS
- Gym Access IND Bronze POS OA Standard 2450 - POS
- Gym Access IND Bronze Standardized HMO - HMO
- Gym Access IND Gold HMO 4500 - HMO
- Gym Access IND Gold HMO BC 5651 - HMO
- Gym Access IND Gold HMO H.S.A 9010 - HMO
- Gym Access IND Gold HMO OA Standard 3450 - HMO
- Gym Access IND Gold POS 55001 - POS
- Gym Access IND Gold POS BC 5651 - POS
- Gym Access IND Gold POS OA Standard 3450 - POS
- Gym Access IND Silver HMO BC 0941 - HMO
- Gym Access IND Silver HMO BC 7741 - HMO
- Gym Access IND Silver HMO OA 1009 - HMO
- Gym Access IND Silver HMO OA Standard 1440 - HMO
- Gym Access IND Silver POS BC 0941 - POS
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| SW13450 | OTHER (01) | FL | FLORIDALCSW LICENSE |
Medicare Participation & PECOS Enrollment Status
Brian Shea is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 32127 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is NA
- Average New Patient Price $0
- Minimum New Patient Price $56
- Maximum New Patient Price $171.84
- Average New Patient Copayment $0
- Minimum New Patient Copayment $14
- Maximum New Patient Copayment $42.96
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $70.04
- Minimum Established Patient Price $17.57
- Maximum Established Patient Price $139.16
- Average Established Patient Copayment $17.51
- Minimum Established Patient Copayment $4.39
- Maximum Established Patient Copayment $34.79
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1023628807, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 53 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 15 providers are registered at the same or a nearby location.
PORT ORANGE, FL 32127
PORT ORANGE, FL 32127
PORT ORANGE, FL 32127
PORT ORANGE, FL 32127
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1023628807, enumerated as an "individual" on August 05, 2020.
The provider is located at 740 DUNLAWTON AVE PORT ORANGE, FL 32127 and the phone number is (386) 763-1000.
Social Worker with taxonomy code 1041C0700X and a focus in Clinical.
The provider might be accepting Accepts: Florida Health Care Plans, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
