Provider Demographics
NPI:1366886574
Name:THORPE, TAINA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:TAINA
Middle Name:
Last Name:THORPE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TAINA
Other - Middle Name:
Other - Last Name:HERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:11705 BOYETTE RD # 248
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33569-5533
Mailing Address - Country:US
Mailing Address - Phone:813-591-4868
Mailing Address - Fax:813-279-2551
Practice Address - Street 1:5118 N 56TH ST STE 128
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33610-5440
Practice Address - Country:US
Practice Address - Phone:813-591-4868
Practice Address - Fax:813-279-2551
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-18
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW152221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024966900Medicaid