NPI 1780960575 · live from the CMS NPI Registry
Tara Elizabeth Anderson, LCSW
Social Worker, Clinical in La Crosse, WI. National Provider Identifier 1780960575, active.
NPI record
| NPI | 1780960575 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 212 11th St S, La Crosse, WI 54601 |
| Practice phone | 608-392-9555 |
| Mailing address | Po Box 1510, Eau Claire, WI 54702 |
| Enumerated | October 25, 2011 |
| Last updated | May 22, 2019 |
| Sole proprietor | No |
| Other names | Tara Proffitt |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 23328 (IL) |
| Social Worker, Clinical | 1041C0700X | 149.012808 (IL) |
| Social Worker, Clinical primary | 1041C0700X | 8160-123 (WI) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.