Individual provider Active NPI

Nicole Okeefe

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1386336360
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW21471 Issued in FL
Practice address
3638 Madaca LN
Tampa, FL 33618-2057
Phone
(813) 968-6610
Fax
(813) 264-1669
NPI assigned
May 25, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW21471 FL Primary

Addresses

Primary practice location

3638 Madaca LN
Tampa, FL 33618-2057

Mailing address

720 Brooker Creek Blvd Ste 215
Oldsmar, FL 34677-2937
Phone (813) 854-2033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW21471FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Health Care Alliance, PA CurrentSince Aug 13, 2023 Accepting new patients
Pediatric Health Care Alliance, PA PastSince Aug 13, 2023 Accepting new patients

Locations

720 Brooker Creek Blvd
Ste 215
Oldsmar, FL 34677
Phone (813) 854-2003

3638 Madaca Ln
Tampa, FL 33618
Phone (813) 968-6610

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1386336360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 BROOKER CREEK BLVD STE 215",
            "city": "OLDSMAR",
            "state": "FL",
            "postal_code": "346772937",
            "telephone_number": "813-854-2033",
            "fax_number": "813-436-5378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3638 MADACA LN",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336182057",
            "telephone_number": "813-968-6610",
            "fax_number": "813-264-1669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKEEFE",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.