Individual provider Active NPI

Tricia Antonio, LCSW

  • Clinical Social Worker
  • Miramar, FL
National Provider Identifier
1861652422
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW 9260 Issued in FL
Practice address
11820 Miramar Pkwy Ste 224
Miramar, FL 33025-5818
Phone
(954) 366-9842
NPI assigned
Jun 16, 2008
Last updated
Mar 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 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 SW 9260 FL Primary

Addresses

Primary practice location

11820 Miramar Pkwy Ste 224
Miramar, FL 33025-5818

Mailing address

5825 Swordfish CT
Unit a
Tamarac, FL 33319-6296
Phone (954) 366-9842

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
I20240222001658 FL Practitioner - Clinical Social Worker 9638306053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW 9260FLMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tga Counseling LLC Clinical CurrentSince Apr 5, 2020 Accepting new patients
Mtca Psychological Services P.a. CurrentSince Feb 1, 2024 Accepting new patients

Locations

7091 Atlantic Ave
Delray Beach, FL 33446
Phone (561) 558-2149

11820 Miramar Pkwy
Ste 224
Miramar, FL 33025
Phone (954) 366-9842

16853 NE 2nd Ave
Ste S304
North Miami Beach, FL 33162

Organizations & group practices 2

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1861652422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5825 SWORDFISH CT",
            "address_2": "UNIT A",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333196296",
            "telephone_number": "954-366-9842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 MIRAMAR PKWY STE 224",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330255818",
            "telephone_number": "954-366-9842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONIO",
        "first_name": "TRICIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 9260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

Verify at the official NPI Registry.