JACQUELYN COUGHLIN (LCSW) – Clinical Social Worker, NPI 1396175980

JACQUELYN COUGHLIN (LCSW) is a healthcare provider. based in Riverview, Florida. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. SW 10963 (FL). The NPI Number for JACQUELYN COUGHLIN (LCSW) is 1396175980

Main info

Female
Sole Proprietor
19 Years Of Experience
Accepts Medicare Assignment
Name
JACQUELYN COUGHLIN (LCSW)
NPI
1396175980
Phone
Not provided
Address
10901 CARNELIAN LN
Enumeration Date
18 November 2013
Last Update Date
18 November 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8133158648
Graduation Year
2007 (19 years ago)
PAC ID
9436389186
Group Practice PAC ID
8527136977
Professional Enrollment ID
I20140226000591
Address ID
FL335118813BR1134XRDXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience38
Completeness75
Years active:12State licenses:1Digital endpointsOther names

3,374 CLINICAL SOCIAL WORKER in FL

Provider Addresses for JACQUELYN COUGHLIN (LCSW)

  • 10901 CARNELIAN LN

    RIVERVIEW, FL 335783915

    Phone:

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-02-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140226000591IClinical Social WorkerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33578)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8527136977View full group profile
NameSpecialtyState
Clinical Social WorkerFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Clinical Social WorkerIN
Clinical Social WorkerFL
Mental Health CounselorFL
Mental Health CounselorFL
Clinical Social WorkerFL
Mental Health CounselorFL
Clinical Social WorkerFL

Reviews

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Frequently asked questions

Can I use this page to confirm JACQUELYN COUGHLIN (LCSW)'s NPI?
Yes. JACQUELYN COUGHLIN (LCSW) is listed with NPI 1396175980 in the public NPI dataset.
Is JACQUELYN COUGHLIN (LCSW) still practicing?
JACQUELYN COUGHLIN (LCSW) is currently listed as active in the public NPI registry.
What taxonomy line describes JACQUELYN COUGHLIN (LCSW)?
For research purposes, treat JACQUELYN COUGHLIN (LCSW) as Clinical Social Worker in this dataset. Clinical services aligned with this taxonomy classification.
What area does JACQUELYN COUGHLIN (LCSW) serve?
JACQUELYN COUGHLIN (LCSW)'s listing highlights Riverview, Florida; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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