Individual provider Active NPI

Tara J Noyes, LICSW

  • Clinical Social Worker
  • Beverly, MA
National Provider Identifier
1043781008
Registry record updated Dec 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
116696 Issued in MA
Practice address
100 Cummings Ctr Ste 108G
Beverly, MA 01915-6251
Phone
(978) 578-9431
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 116696 MA Primary

Addresses

Primary practice location

100 Cummings Ctr Ste 108G
Beverly, MA 01915-6251

Mailing address

100 Cummings Ctr Ste 108G
Beverly, MA 01915-6251
Phone (978) 578-9431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251201000688 MA Practitioner - Clinical Social Worker 6800389743 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1099 18TH St
Suite 2350
Denver, CO 80202-1926

PO Box
Dallas, TX 75373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
116696MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sondermind Provider Network LLC Clinical CurrentSince Oct 1, 2025 Accepting new patients

Locations

90 Canal St
Ste 4
Boston, MA 02114
Phone (617) 517-4889

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544918400000",
    "number": "1043781008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 108G",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156251",
            "telephone_number": "978-578-9431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CUMMINGS CTR STE 108G",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019156251",
            "telephone_number": "978-578-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOYES",
        "first_name": "TARA",
        "middle_name": "J",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "116696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.