Individual provider Active NPI

Tamara Whiteman Haberman, LCSW

  • Clinical Social Worker
  • Davenport, FL
National Provider Identifier
1407119548
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3300 Issued in FL
Practice address
321 Boxwood Dr
Davenport, FL 33837-5501
Phone
(407) 924-2389
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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 3300 FL Primary

Addresses

Primary practice location

321 Boxwood Dr
Davenport, FL 33837-5501

Mailing address

321 Boxwood Dr
Davenport, FL 33837-5501
Phone (407) 924-2389

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120719000357 FL Practitioner - Clinical Social Worker 7618133646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Che Behavioral Health Services of Florida, P.a.Group PAC ID 5698185775, 31 clinicians

Practice addresses (Care Compare)

6750 N Andrews Ave
Suite 200
Ft Lauderdale, FL 33309-2180
Phone (888) 515-3834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Che Behavioral Health Services of Florida, P.a. Clinical CurrentSince Mar 1, 2021 Accepting new patients

Locations

6750 N Andrews Ave
Ste 200
Lauderdale Lakes, FL 33309
Phone (718) 408-5477

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1407119548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 BOXWOOD DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375501",
            "telephone_number": "407-924-2389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BOXWOOD DR",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375501",
            "telephone_number": "407-924-2389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABERMAN",
        "first_name": "TAMARA",
        "middle_name": "WHITEMAN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "3300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.