Active NPI
Tara Elizabeth Kung Li Newcomer, LCSW-C
- Clinical Social Worker
- Stevensville, MD
National Provider Identifier
1235731035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 21804
- Practice address
- 139 Log Canoe Cir
Stevensville, MD 21666-2127 - Phone
- (443) 282-8720
- NPI assigned
- Nov 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 21804 | MD | Primary |
Addresses
Primary practice location
139 Log Canoe Cir
Stevensville, MD 21666-2127
Mailing address
117 Chews Manor Rd
Stevensville, MD 21666-3873
Phone (240) 357-7415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21804 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1235731035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 CHEWS MANOR RD",
"city": "STEVENSVILLE",
"state": "MD",
"postal_code": "216663873",
"telephone_number": "240-357-7415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 LOG CANOE CIR",
"city": "STEVENSVILLE",
"state": "MD",
"postal_code": "216662127",
"telephone_number": "443-282-8720"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWCOMER",
"first_name": "TARA",
"middle_name": "ELIZABETH KUNG LI",
"credential": "LCSW-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-11-16",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "21804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stevensville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.