Individual provider Active NPI

Kieara Pittman

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1083288476
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1503 S US Highway 301
Tampa, FL 33619-5126
Phone
(813) 509-9647
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1503 S US Highway 301
Tampa, FL 33619-5126

Mailing address

610 Rooks Rd
Seffner, FL 33584-3953
Phone (813) 509-9647

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL counselingandwellnessboutique.com Other Counseling & Wellness Boutique LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1083288476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 ROOKS RD",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335843953",
            "telephone_number": "813-509-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 S US HIGHWAY 301",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336195126",
            "telephone_number": "813-509-9647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "KIEARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "counselingandwellnessboutique.com",
            "affiliation": "Y",
            "endpointDescription": "Mental Health Counseling",
            "affiliationName": "Counseling & Wellness Boutique LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Business",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Mental Health Counseling",
            "address_1": "1503 S US Highway 301 Ste E16",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336195126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 May 19, 2021; 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.