MEDICARE: MRS. TAINA THORPE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW15222	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366886574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAINA THORPE LCSW

Provider Business Mailing Address
First Line	:	11705 BOYETTE RD # 248
Second Line	:
City	:	RIVERVIEW
State	:	FL
Zip	:	33569-5533
Country	:	US
Telephone Number	:	813-591-4868
Fax Number	:	813-279-2551

Provider Business Practice Location Address
First Line	:	5118 N 56TH ST STE 128
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-5440
Country	:	US
Telephone Number	:	813-591-4868
Fax Number	:	813-279-2551

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	09/05/2024

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