Individual provider Active NPI

Elizabeth Jane Tarr, LLMSW

  • Clinical Social Worker
  • Canton, MI
National Provider Identifier
1164650776
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801091254 Issued in MI
Practice address
43825 Michigan Ave
Canton, MI 48188-2551
Phone
(734) 397-3088
Fax
(734) 397-2892
NPI assigned
Jun 23, 2009
Last updated
Oct 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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 6801091254 MI Primary

Addresses

Primary practice location

43825 Michigan Ave
Canton, MI 48188-2551

Mailing address

5680 N Christine
Apt 102
Westland, MI 48185-3195
Phone (734) 891-0436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1164650776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 N CHRISTINE",
            "address_2": "APT 102",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481853195",
            "telephone_number": "734-891-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43825 MICHIGAN AVE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882551",
            "telephone_number": "734-397-3088",
            "fax_number": "734-397-2892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARR",
        "first_name": "ELIZABETH",
        "middle_name": "JANE",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-23",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

Verify at the official NPI Registry.