Timothy Slattery, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW21991 Issued in FL

Practice address

12734 Kenwood LN Ste 79
Fort Myers, FL 33907-5638

Phone

(239) 970-4911

NPI assigned

Apr 1, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Foxtrot Whiskey Tango LLC

  • Clinical Social Worker
  • Fort Myers, FL
  • NPI 1568333011
  NPD

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

{
    "created_epoch": "1270080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1902121999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 NW 39TH AVE",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339935507",
            "telephone_number": "239-771-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12734 KENWOOD LN STE 79",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339075638",
            "telephone_number": "239-970-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATTERY",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-01",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW21991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Curtis W Skupny, D.P.M.
• Sky'S the Limit ABA Therapy LLC
• Stephanie K Slagle, M.D.
• Jason Andrew Slate, MD
• Diana Lynn Slater, OTA
• Roberta Slauterbeck, CNP
• David R Slavens, D.C.
• Sleep Management Centers LLC
• Marva Kay Sletten, PT
• Terrell Gene Sletten

• Clinical Social Worker in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2025; 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.