Healthcare Provider Details

I. General information

NPI: 1255473773
Provider Name (Legal Business Name): TAMRA S CAJO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4620 17TH ST
SARASOTA FL
34235-1843
US

IV. Provider business mailing address

2908 MAYFLOWER ST
SARASOTA FL
34231-6122
US

V. Phone/Fax

Practice location:
  • Phone: 941-371-8820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: