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ETTA ETTLINGER, LCSW, PA
NPI 1932384351
Social Worker - Clinical in Ponte Vedra, FL

Active since January 03, 2008
100 EXECUTIVE WAY STE 110, PONTE VEDRA, FL 32082(904) 273-4099(904) 273-4095 Get Directions Write a Review

NPPES record last updated: January 3, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Etta Ettlinger, Lcsw, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETTA ETTLINGER, LCSW, PA (NPI 1932384351) is a healthcare organization registered as a clinical in Ponte Vedra, Florida and active in the NPI registry since January 2008. The organization lists Etta F. Ettlinger, Clinical Social Worker, as its authorized official.

NPPES Registry Identity

NPI1932384351
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameETTA ETTLINGER, LCSW, PA
Location Address100 EXECUTIVE WAY STE 110Ponte Vedra, FL 32082-4753
Mailing Address100 Executive Way Ste 110Ponte Vedra, FL 32082-4753 · (904) 273-4099 · Fax (904) 273-4095
Phone(904) 273-4099
Fax(904) 273-4095
Organization SubpartNo
Authorized OfficialEtta F. EttlingerClinical Social Worker · (904) 273-4099
Enumeration DateJanuary 3, 2008
✔ NPI 1932384351 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in FL · SW6310
Definition
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.
100 EXECUTIVE WAY STE 110, Ponte Vedra, FL 32082
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Other Identifiers 1

Medicare UPINZ003PAFL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Etta Ettlinger, Lcsw, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Etta Ettlinger, Lcsw, PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Etta Ettlinger, LCSW
Clinical Social Worker
NPI 1144207713
100 EXECUTIVE WAY SUITE #110
Ponte Vedra, FL 32082
(904) 273-4099
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Etta Ettlinger, Lcsw, PA's NPI number?

The NPI number for Etta Ettlinger, Lcsw, PA is 1932384351. It was assigned to this organization in the NPPES registry on January 3, 2008.

Where is Etta Ettlinger, Lcsw, PA located?

Etta Ettlinger, Lcsw, PA is located at 100 Executive Way Ste 110, Ponte Vedra, FL 32082. The listed phone number is (904) 273-4099.

What is Etta Ettlinger, Lcsw, PA's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Etta Ettlinger, Lcsw, PA enrolled in Medicare?

Yes. Etta Ettlinger, Lcsw, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Etta Ettlinger, Lcsw, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Etta Ettlinger, Lcsw, PA. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Etta Ettlinger, Lcsw, PA was last updated on January 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.