NPIMap

Organization Active NPI

Lisa Bentivenga LCSW P LLC

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1053763169
Registry record updated Apr 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11270 Issued in FL
Legal business name
LISA BENTIVENGA LCSW P LLC
Practice address
322 W Bearss Ave
Tampa, FL 33613-1228
Phone
(813) 505-1949
Fax
(813) 651-5465
NPI assigned
Jul 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2017

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

Authorized official

Name
Lisa Bentivenga, LCSW
Title
LSCW
Phone
(813) 505-1949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW11270 FL Primary

Addresses

Primary practice location

322 W Bearss Ave
Tampa, FL 33613-1228

Mailing address

4010 Harbor Lake Dr
Lutz, FL 33558-9731
Phone (813) 505-1949

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492387200000",
    "number": "1053763169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 HARBOR LAKE DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335589731",
            "telephone_number": "813-505-1949",
            "fax_number": "813-651-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 W BEARSS AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336131228",
            "telephone_number": "813-505-1949",
            "fax_number": "813-651-5465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA BENTIVENGA LCSW P LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-13",
        "last_updated": "2017-04-17",
        "status": "A",
        "authorized_official_last_name": "BENTIVENGA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "LSCW",
        "authorized_official_telephone_number": "813-505-1949",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2017; 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.