Tamara Jo Tridle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW19901 Issued in FL

Practice address

1777 Tamiami TRL
Port Charlotte, FL 33948-1078

Phone

(941) 780-4268

NPI assigned

May 5, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

• Dandelion Behavioral Health LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Charlotte, FL
  • NPI 1053028787

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1651708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669334400000",
    "number": "1619612439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25443 ESTRADA CIRCLE",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "33955",
            "telephone_number": "402-217-4555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 TAMIAMI TRL",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339481078",
            "telephone_number": "941-780-4268"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 Purus St",
            "address_purpose": "LOCATION",
            "city": "Punta Gorda",
            "state": "FL",
            "postal_code": "339834227",
            "country_code": "US",
            "telephone_number": "402-217-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRIDLE",
        "first_name": "TAMARA",
        "middle_name": "JO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-05",
        "last_updated": "2022-11-25",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Traficante, PHARMD
• Transitions Family Health Care, Corp.
• Liliana Triana Machado
• Eduardo R. Triana, PT
• Elizabeth Alice Triana, M.D.
• Jeanne Trifone, PSYD
• Alison Beth Trimble, FNP-C
• Brian Richard Triola, MD
• Tropical Breeze Health Care LLC
• Trucare Med, Inc

• Clinical Social Worker in Port Charlotte, FL
• Providers in Port Charlotte, 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 Nov 25, 2022; 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.