Gerik Mark Tatarzycki, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007805A Issued in IN

Practice address

203 Wells St Apt 101
Jackson, TN 38301-7788

Phone

(937) 672-6968

NPI assigned

Jun 25, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529884800000",
    "number": "1255826004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 WELLS ST APT 101",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017788",
            "telephone_number": "937-672-6968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 WELLS ST APT 101",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017788",
            "telephone_number": "937-672-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATARZYCKI",
        "first_name": "GERIK",
        "middle_name": "MARK",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-25",
        "last_updated": "2018-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007805A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley N Tanner III, PHARMACIST
• Cathy Christine Tanner, LPC
• David J Tanner, PHARMACIST
• Shaylon Tanner, LPN IV
• Andrew Tanyous, DDS
• Cindy D Tate, RN
• Katherine Tate, OTR/L
• Norwood Tatman, OT
• Taylor Medical Center, PLLC
• Mechelle Taylor Moragne, MD

• Clinical Social Worker in Jackson, TN
• Providers in Jackson, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.