Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

MS. Kettia Duperval, LCSW

Individual provider Clinical Social Worker · NPI 1164733895

MS. Kettia Duperval, LCSW is a Clinical Social Worker in Miramar, Florida. Qualified in 2012, 14 years ago. Practices with Brightside Health Inc, a 215-clinician group, works from 3 locations, accepts Medicare assignment and offers telehealth. Licensed in Florida and Oregon.

Years since qualifying
14
Licensed in
FL, OR
In the registry since
2010
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

9730 Glacier Dr
Miramar, FL 33025-4407
Phone: (954) 993-1646
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1401 S Federal Hwy, Fort Lauderdale, FL 33316-2619 — (954) 728-1048
  • 11 Sw 5th Ave, Portland, OR 97204-3604 — (323) 205-7088

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence SW20578 (FL)
Clinical Social Worker Taxonomy 1041C0700X · Licence L15870 (OR)

Record details

NPI number1164733895
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJune 28, 2010
Last updated in NPPESMarch 19, 2026
Certification dateMarch 19, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Brightside Health Inc — 215 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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