Individual provider Active NPI

Thomas Patitucci, LCSW

  • Clinical Social Worker
  • Largo, FL
National Provider Identifier
1689296535
Registry record updated May 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
071058-01 Issued in NY
Practice address
12025 68TH Way
Largo, FL 33773-3332
Phone
(908) 577-2181
NPI assigned
May 14, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 071058-01 NY Primary

Addresses

Primary practice location

12025 68TH Way
Largo, FL 33773-3332

Mailing address

12025 68TH Way
Largo, FL 33773-3332
Phone (908) 577-2181

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
071058-01NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1689296535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12025 68TH WAY",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733332",
            "telephone_number": "908-577-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12025 68TH WAY",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337733332",
            "telephone_number": "908-577-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATITUCCI",
        "first_name": "THOMAS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-14",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "071058-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.