Tina Marie Marsicano, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12843 Issued in FL

Practice address

2301 Glades Rd Ste 700
Boca Raton, FL 33431-7397

Phone

(800) 600-4096

NPI assigned

Nov 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2018 through Jul 1, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• 139 Education, LLC.

  • Psychologist
  • Grandville, MI
  • NPI 1013294628
  NPD (past)

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": []
}

• 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
• Martin Shank DPM PA & Richard Nettboy DPM
• Alejandra Martin

• Clinical Social Worker in Boca Raton, FL
• Providers in Boca Raton, 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 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.

Verify at the official NPI Registry.