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NPI Code Detail

MEDICARE: MRS. URSULA GOINES-AUDREY LCSW

MEDICARE: MRS. URSULA GOINES-AUDREY LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerSW24133FL
2101YM0800XMental Health CounselorSW24133FL

General Provider Information

NPI Number : 1497566251
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. URSULA GOINES-AUDREY LCSW
Provider Business Mailing Address
First Line : 3225 DOWNAN POINT DR
Second Line :
City : LAND O LAKES
State : FL
Zip : 34638-7815
Country : US
Telephone Number : 808-753-2743
Fax Number :
Provider Business Practice Location Address
First Line : 126 LITHIA PINECREST RD
Second Line :
City : BRANDON
State : FL
Zip : 33511-5347
Country : US
Telephone Number : 813-689-8828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2025
Last Update Date : 01/27/2026

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