Nyssa Jae Tai, LCSW, MCAP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW12579 Issued in FL

Practice address

232 N Orange Blossom TRL
Orlando, FL 32805-1612

Phone

(407) 428-5751

NPI assigned

Nov 7, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Nyssa Jae Olness Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1942554340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051612",
            "telephone_number": "407-428-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 N ORANGE BLOSSOM TRL",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051612",
            "telephone_number": "407-428-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAI",
        "first_name": "NYSSA",
        "middle_name": "JAE",
        "credential": "LCSW, MCAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW12579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL PRATICTITIONER LINKED TO AN ORGANIZATION",
            "identifier": "IE922Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NYSSA",
            "last_name": "OLNESS",
            "middle_name": "JAE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jamal M Taha
• Imad Tahbub, MD
• Naghmeh Taherian, DMD
• Usama Bin Tahir, M.D.
• Naziya Tahseen, MD
• Amisha Tailor, PHARMD
• Dharmesh Tailor, MD
• Ou Taing, PHARMD
• Robert E Tainsh, MD, MPH
• Laura Frances Tait, M.D.

• Clinical Social Worker in Orlando, FL
• Providers in Orlando, 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 Jan 23, 2018; 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.