Individual provider Active NPI

Tara Haddon, LMSW

  • Social Worker
  • Topeka, KS
National Provider Identifier
1164836292
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
9170 Issued in KS
Practice address
325 SW Frazier Ave
Topeka, KS 66606-1963
Phone
(785) 232-5005
Fax
(785) 232-0160
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 9170 KS Primary

Addresses

Primary practice location

325 SW Frazier Ave
Topeka, KS 66606-1963

Mailing address

325 SW Frazier Ave
Topeka, KS 66606-1963
Phone (785) 232-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20210120002582 KS Practitioner - Clinical Social Worker 9133533854 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9170KSMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Interpersonal Psychiatry, LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

1045 E 23rd St
Lawrence, KS 66046
Phone (785) 727-0126

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": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1164836292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SW FRAZIER AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061963",
            "telephone_number": "785-232-5005",
            "fax_number": "785-232-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 SW FRAZIER AVE",
            "city": "TOPEKA",
            "state": "KS",
            "postal_code": "666061963",
            "telephone_number": "785-232-5005",
            "fax_number": "785-232-0160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDON",
        "first_name": "TARA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "9170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Topeka, KS

Sources for this page

Verify at the official NPI Registry.