Tom Wasik, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW 11703 Issued in FL

Practice address

2312 Wilton Dr
Ste 21
Wilton Manors, FL 33305-1114

Phone

(631) 848-0696

NPI assigned

Nov 29, 2007

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1265614416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 NE 24TH ST",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051316",
            "telephone_number": "631-848-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 WILTON DR",
            "address_2": "STE 21",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333051114",
            "telephone_number": "631-848-0696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASIK",
        "first_name": "TOM",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-29",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "073838",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 11703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary-Eileen Walker, MS
• Paul Lexington Walker, D.P.M.
• Sarah A Walker, LMFT
• David Keith Warner, D.D.S.
• Lindsay Warner, MSW
• Charmaine Marcia Weatherly, LCSW
• Barry S Weinberg, DC
• Welcome Home
• Wellington Pharmacy Inc
• Wellington Pharmacy Inc

• Clinical Social Worker in Wilton Manors, FL
• Providers in Wilton Manors, 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 26, 2014; 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.