Tracey Marie Aittama, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

ISW4110 Issued in FL

Practice address

10611 NW State Road 20
Bristol, FL 32321-3441

Phone

(850) 643-1033

NPI assigned

Oct 21, 2020

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Community Wellness Counseling and Support Services

  • Clinical Social Worker
  • Bristol, FL
  • NPI 1881047041
  NPD (past)

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1295334241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4228 GROVE PARK DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323111613",
            "telephone_number": "850-855-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10611 NW STATE ROAD 20",
            "city": "BRISTOL",
            "state": "FL",
            "postal_code": "323213441",
            "telephone_number": "850-643-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AITTAMA",
        "first_name": "TRACEY",
        "middle_name": "MARIE",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "ISW4110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TAittama@cwcssbh.com",
            "affiliation": "Y",
            "affiliationName": "Community Wellness Counseling and Support Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "12958 NW Collins Hill Ln",
            "city": "Bristol",
            "state": "FL",
            "country_code": "US",
            "postal_code": "323213188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Katie Leigh Askew, RPH
• Lindsay Marie Bailey, LPN
• Damien Bentley

• Social Worker in Bristol, FL
• Providers in Bristol, FL by specialty
• Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.