Tabitha Grant Dimino, LMFT, MCAP, ICRC-ADA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT3149 Issued in FL

Practice address

1717 20TH St Ste 102
Vero Beach, FL 32960-0619

Phone

(772) 584-2501

NPI assigned

Apr 24, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Tabitha Lynn Grant Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 21, 2025 through Jan 21, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Psychotherapy Center of Indian River LLC

  • Mental Health Counselor
  • Vero Beach, FL
  • NPI 1689334724
  NPD

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

{
    "created_epoch": "1335225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660435200000",
    "number": "1487912705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 20TH ST STE 102",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600619",
            "telephone_number": "772-584-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 20TH ST STE 102",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329600619",
            "telephone_number": "772-584-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMINO",
        "first_name": "TABITHA",
        "middle_name": "GRANT",
        "credential": "LMFT, MCAP, ICRC-ADA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-24",
        "last_updated": "2022-08-14",
        "certification_date": "2022-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "ADC-010451-2015",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH10719",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT3149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TABITHA",
            "last_name": "GRANT",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.