Active NPI
Tristan Freedman, MSW
- Clinical Social Worker
- Weston, FL
National Provider Identifier
1417738576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- SW12504
- Practice address
- 19549 N Coquina Way
Weston, FL 33332 - Phone
- (754) 778-7887
- Fax
- (754) 778-8070
- NPI assigned
- Oct 13, 2023
- Last updated
- Oct 13, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | SW12504 | FL | Primary |
Addresses
Primary practice location
19549 N Coquina Way
Weston, FL 33332
Mailing address
10771 Bexley Blvd
Boca Raton, FL 33428
Phone (954) 895-7075
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SW12504 | FL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697155200000",
"number": "1417738576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10771 BEXLEY BLVD",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "33428",
"telephone_number": "954-895-7075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19549 N COQUINA WAY",
"city": "WESTON",
"state": "FL",
"postal_code": "33332",
"telephone_number": "754-778-7887",
"fax_number": "754-778-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREEDMAN",
"first_name": "TRISTAN",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-13",
"last_updated": "2023-10-13",
"certification_date": "2023-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "FL",
"license": "SW12504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Weston, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.