Organization Active NPI

Tamara Gorfine-Petrelli, LLC

  • Clinical Social Worker
  • West Palm Beach, FL
National Provider Identifier
1851843056
Registry record updated Nov 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11884 Issued in FL
Legal business name
TAMARA GORFINE-PETRELLI, LLC
Practice address
1645 Palm Beach Lakes Blvd
1200
West Palm Beach, FL 33401-2204
Phone
(561) 662-6900
NPI assigned
Nov 4, 2016
Last updated
Nov 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2016

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

Authorized official

Name
Tamara Petrelli, LCSWNPI 1629290234
Title
Owner
Phone
(561) 662-6900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW11884 FL Primary

Addresses

Primary practice location

1645 Palm Beach Lakes Blvd
1200
West Palm Beach, FL 33401-2204

Mailing address

1645 Palm Beach Lakes Blvd
1200
West Palm Beach, FL 33401-2204
Phone (561) 662-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190408001714 FL Part B Supplier - Clinic/Group Practice 9537400288 Receives reassigned benefits from 2 practitioners
Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

Locations

1645 Palm Beach Lakes Blvd
Ste 1200
West Palm Beach, FL 33401
Phone (561) 257-1877

1655 Palm Beach Lakes Blvd
Ste 412
West Palm Beach, FL 33401
Phone (561) 662-6900

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478217600000",
    "number": "1851843056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 PALM BEACH LAKES BLVD",
            "address_2": "1200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012204",
            "telephone_number": "561-662-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 PALM BEACH LAKES BLVD",
            "address_2": "1200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012204",
            "telephone_number": "561-662-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMARA GORFINE-PETRELLI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A",
        "authorized_official_last_name": "PETRELLI",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-662-6900",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.