Individual provider Active NPI

Charisse T Reid

  • Clinical Social Worker
  • Tampa, FL
National Provider Identifier
1679113906
Registry record updated Dec 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW21485 Issued in FL
Practice address
12512 Bruce B Downs Blvd
Tampa, FL 33612-9209
Phone
(813) 693-2516
NPI assigned
Jan 15, 2020
Last updated
Dec 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2023

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 SW21485 FL Primary
Clinical Social Worker 1041C0700X ISW13760 FL

Addresses

Primary practice location

12512 Bruce B Downs Blvd
Tampa, FL 33612-9209

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 315-7496

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Charisse.ReidLCSW@direct.mybaycare.org Health Information Exchange (HIE) BayCare Behavioral Health Inc.

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
I20230606002653 FL Practitioner - Clinical Social Worker 7911364963 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tampa Family Health Centers IncGroup PAC ID 1254243769, 66 clinicians

Practice addresses (Care Compare)

4620 N 22ND St
Tampa, FL 33610-6205
Phone (813) 397-5300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ISW13760FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Behavioral Health Inc. Current Accepting new patients
Tampa Family Health Centers Inc CurrentSince Jul 1, 2025 Accepting new patients
Baycare Behavioral Health Inc. CurrentSince Jul 9, 2023 Accepting new patients
Northside Behavioral Health Center, Inc. CurrentSince May 30, 2022 Accepting new patients
Baycare Behavioral Health, Inc CurrentSince Jul 9, 2023 Accepting new patients
Tampa Family Health Centers, Inc CurrentSince Jul 1, 2025 Accepting new patients
Mind Body Spirit Therapist Collective LLC Current Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 281-9390

7809 Massachusetts Ave
Ste 100
New Prt Rchy, FL 34653
Phone (727) 841-4200

12085 W Hillsborough Ave
Tampa, FL 33635
Phone (813) 852-5270

12512 Bruce B Downs Blvd
Tampa, FL 33612
Phone (813) 977-8700

302 W Fletcher Ave
Tampa, FL 33612

7814 N Dale Mabry Hwy
Tampa, FL 33614
Phone (813) 405-3939

Interoperability endpoints

  • Direct secure messaging: charisse.reidlcsw@direct.mybaycare.org

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703548800000",
    "number": "1679113906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-315-7496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12512 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336129209",
            "telephone_number": "813-693-2516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "CHARISSE",
        "middle_name": "T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2023-12-26",
        "certification_date": "2023-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21485",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "ISW13760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Charisse.ReidLCSW@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Behavioral Health Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12512 Bruce B Downs Blvd",
            "city": "Tampa",
            "state": "FL",
            "country_code": "US",
            "postal_code": "336129209",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.