Tanya Scroggins Gulledge, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW16397 Issued in FL

Practice address

2944 Penn Ave Ste L
Marianna, FL 32448-2741

Phone

(850) 526-5500

NPI assigned

Jun 6, 2019

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

Enrolled in FL

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Chrysalis Center, LLC

  • Community/Behavioral Health Agency
  • Fort Lauderdale, FL
  • NPI 1700961646
  Medicare reassignment NPD
• Florida Therapy Services, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pensacola, FL
  • NPI 1407427800
  NPD

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1245899913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3687 BASS RD",
            "city": "GRACEVILLE",
            "state": "FL",
            "postal_code": "324407205",
            "telephone_number": "850-373-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2944 PENN AVE STE L",
            "city": "MARIANNA",
            "state": "FL",
            "postal_code": "324482741",
            "telephone_number": "850-526-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLEDGE",
        "first_name": "TANYA",
        "middle_name": "SCROGGINS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW16397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Hoff Green, ARNP
• Lori A Gregg
• Gregory a. Lambe, D.C., P.a.
• Elizabeth Delaine Griffin, LMHC
• Johnny Guest, LICENSED AID DEALER
• David W Gullett, CRNA
• Mary Gurganus, ND
• Habilitative Services of North Florida
• Leslie A. Hall, IMH
• Robert Michael Hall, ARNP

• Clinical Social Worker in Marianna, FL
• Providers in Marianna, 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 6, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.