Active NPI
Tina Marie Marsicano, LCSW
- Clinical Social Worker
- Boca Raton, FL
National Provider Identifier
1194122879
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW12843
- Practice address
- 2301 Glades Rd Ste 700
Boca Raton, FL 33431-7397 - Phone
- (800) 600-4096
- NPI assigned
- Nov 25, 2014
- Last updated
- Mar 17, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 081475-1 | NY | |
| Clinical Social Worker | 1041C0700X | SW12843 | FL | Primary |
Addresses
Primary practice location
2301 Glades Rd Ste 700
Boca Raton, FL 33431-7397
Mailing address
201 Monroe Ave NW Ste 300
Grand Rapids, MI 49503-2212
Phone (800) 600-4096
Other practice location 1
2650 Pga Blvd
Palm Beach Gardens, FL 33410-2904
Phone (800) 600-4096
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jul 1, 2018 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 081475-1 | NY | MD | Mental Health Counselor |
| SW12843 | FL | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 139 Education, LLC. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1194122879",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 MONROE AVE NW STE 300",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495032212",
"telephone_number": "800-600-4096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 GLADES RD STE 700",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334317397",
"telephone_number": "800-600-4096"
}
],
"practiceLocations": [
{
"address_1": "2650 Pga Blvd",
"address_purpose": "LOCATION",
"city": "Palm Beach Gardens",
"state": "FL",
"postal_code": "334102904",
"country_code": "US",
"telephone_number": "800-600-4096",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARSICANO",
"first_name": "TINA",
"middle_name": "MARIE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-25",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "081475-1",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW12843",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boca Raton, FL
- Colvin Marcus Marshall, CMMP, LMT
- Dennis Yasuda Marshall, RRT
- Jennifer Nicole Marshall, PA-C
- Tatyana Marshall, LCSW
- Bradley Allen Marsic, MS, LAT, ATC
- Estrellita Marte, PA-C
- Martin G. Bloom, MD, PA
- Martin Shank DPM PA & Richard Nettbay DPM (BOCA Deerfield Podiatry Associates)
- Martin Shank DPM PA & Richard Nettboy DPM (BOCA Deerfield Podiatry Associates)
- Alejandra Martin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.