IndividualActive
Rose Lickenbrock, LCSW
NPI 1619624012 · Clinical Social Worker · Ponte Vedra Beach, FL
Provider details
- NPI number
- 1619624012
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- Yes
- License
- SW6040 (FL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(61/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
116 Old Mill Ct
Ponte Vedra Beach, FL 32082-4133
Phone: (904) 537-7649
Street-level locationGet directions
Mailing address
116 Old Mill Ct
Ponte Vedra Beach, FL 32082-4133
Registry dates
- Enumerated
- 2022-03-05
- Last updated
- 2022-03-05
- Certified
- 2022-03-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.