Individual provider Active NPI

Andrea Tuttle, MSW LCSW

  • Clinical Social Worker
  • Fort Myers, FL
National Provider Identifier
1629437934
Registry record updated Feb 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11147 Issued in FL
Practice address
1473 Barcelona Ave
Fort Myers, FL 33901-6642
Phone
(919) 923-4633
NPI assigned
Feb 15, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW11147 FL Primary
Clinical Social Worker 1041C0700X C009067 NC

Addresses

Primary practice location

1473 Barcelona Ave
Fort Myers, FL 33901-6642

Mailing address

1473 Barcelona Ave
Fort Myers, FL 33901-6642
Phone (919) 923-4633

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
SW11147FLMDClinical Social Worker
C009067NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455494400000",
    "number": "1629437934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1473 BARCELONA AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339016642",
            "telephone_number": "919-923-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1473 BARCELONA AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339016642",
            "telephone_number": "919-923-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTTLE",
        "first_name": "ANDREA",
        "credential": "MSW LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11147",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C009067",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.