Radically Open DBT Tampa

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RADICALLY OPEN DBT TAMPA

Practice address

1341 Windsor Way
Lutz, FL 33559-6742

Phone

(813) 602-2312

Fax

(813) 336-8506

NPI assigned

Apr 19, 2020

Organization subpart

No

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

Authorized official

Name

Heidi A Ison-Lustberg, LCSW

Title

Owner

Phone

(813) 602-2312

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Courtney Gowen, LCSW

  • Social Worker
  • Tampa, FL
  • NPI 1508489915

  Clinical

  NPD (past)

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

{
    "created_epoch": "1587254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735344000000",
    "number": "1316567472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2751 EAST COUNTY LINE RD",
            "address_2": "PMB #300",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335593439",
            "telephone_number": "813-602-2312",
            "fax_number": "813-302-1173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 WINDSOR WAY",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335596742",
            "telephone_number": "813-602-2312",
            "fax_number": "813-336-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADICALLY OPEN DBT TAMPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-19",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A",
        "authorized_official_last_name": "ISON-LUSTBERG",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-602-2312",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cierra Ryan Quigley, CCC-SLP
• Isabel A Quijano, RD, LD/N
• Jessica Lauren Quintana, MSW, LCSW
• Liana Megan Raborn, APRN
• Rad Gharavi MD PC
• Radice Family Chiropractic, P.a.
• Michael Radice, D.C.
• Hunter M Radin, OTD
• Alek Jovany Radon
• Martha Radon

• Clinical Social Worker in Lutz, FL
• Providers in Lutz, 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 Dec 28, 2024; 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.