Tina Faye Summers, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2343C Issued in AL

Practice address

17046 N Hagler Rd
Northport, AL 35475-5024

Phone

(207) 292-8278

NPI assigned

Aug 21, 2019

Last updated

Oct 26, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1821645128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17046 N HAGLER RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354755024",
            "telephone_number": "205-292-8278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17046 N HAGLER RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354755024",
            "telephone_number": "207-292-8278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERS",
        "first_name": "TINA",
        "middle_name": "FAYE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "2343C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "SimplePractice.com",
            "affiliation": "N",
            "endpointDescription": "office software",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3200 Clements Rd",
            "city": "Cottondale",
            "state": "AL",
            "country_code": "US",
            "postal_code": "354532137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Steven Roland Straughn, CRNA
• Carol Ellis Strickland, CRNP
• Bobbie C Sullivan, CRNP, FNP
• Regina Angela Sullivan, PTA
• Kerim Sumengen
• Sharon Lynn Sutton, OTRL
• Ashraf Ahsan Syed, M.D.
• T Mark Norris (Norris Limb and Brace)
• Danielle Tant, CRNP
• Teresa B. Taylor, M.A,

• Clinical Social Worker in Northport, AL
• Providers in Northport, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.