Healthcare Provider Details

I. General information

NPI: 1417884115
Provider Name (Legal Business Name): TANESHEA SARGENT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 OKEECHOBEE BLVD
WEST PALM BEACH FL
33409-3204
US

IV. Provider business mailing address

4324 BERKSHIRE WHARF DR
LAKE WORTH FL
33461-4990
US

V. Phone/Fax

Practice location:
  • Phone: 561-715-5910
  • Fax:
Mailing address:
  • Phone: 561-856-4148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW22596
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: