Individual provider Active NPI

Tiffany M. Castellanos, LCSW

  • Clinical Social Worker
  • Safety Harbor, FL
National Provider Identifier
1932253143
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW11795 Issued in FL
Practice address
108 4TH Ave S Ste B
Safety Harbor, FL 34695-4020
Phone
(813) 720-7411
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C005374 NC
Clinical Social Worker 1041C0700X SW11795 FL Primary

Addresses

Primary practice location

108 4TH Ave S Ste B
Safety Harbor, FL 34695-4020

Mailing address

108 4TH Ave S Ste B
Safety Harbor, FL 34695-4020
Phone (813) 720-7411

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
C005374NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Bailey Psychology Group P a CurrentSince Oct 6, 2019 Accepting new patients

Locations

108 4th Ave S
Ste B
Safety Harbor, FL 34695
Phone (813) 720-7411

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1932253143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 4TH AVE S STE B",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346954020",
            "telephone_number": "813-720-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 4TH AVE S STE B",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "346954020",
            "telephone_number": "813-720-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLANOS",
        "first_name": "TIFFANY",
        "middle_name": "M.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005374",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.