Tara Leigh Sullivan-Butrica, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW021944 Issued in PA

Practice address

4700 N Congress Ave Suite 301
West Palm Beach, FL 33407-2117

Phone

(856) 454-3104

NPI assigned

Oct 26, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1013671080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 CEDARCROFT AVE",
            "city": "AUDUBON",
            "state": "NJ",
            "postal_code": "081062117",
            "telephone_number": "215-594-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N CONGRESS AVE SUITE 301",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072117",
            "telephone_number": "856-454-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN-BUTRICA",
        "first_name": "TARA",
        "middle_name": "LEIGH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sabrina Suero, M.S.
• Sujay Trivedi DMD PA
• Osama Sheikh Sulaiman
• Guadalupe Sulbaran, APRN
• Milva E Sulca
• Rebecca Sullivan, DPT
• Steven Nicholas Sullivan
• Mehrunnisa Sultana, M.D.
• Spencer Hall Summers, MD
• Summit Diagnostic Corp.

• Clinical Social Worker in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.