Individual provider Active NPI

Tara Bailey, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
National Provider Identifier
1285065235
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW021098 Issued in PA
Practice address
155 East St
Philadelphia, PA 19127-1805
Phone
(215) 436-9222
NPI assigned
Dec 2, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC05544700 NJ
Clinical Social Worker 1041C0700X CW021098 PA Primary

Addresses

Primary practice location

155 East St
Philadelphia, PA 19127-1805

Mailing address

155 East St
Philadelphia, PA 19127-1805
Phone (215) 436-9222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20210325000289 PA Practitioner - Clinical Social Worker 8921386442 Reassigns benefits to 1 organization
Practice locations: Philadelphia, PA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

123 Chestnut St
Suite 304
Philadelphia, PA 19106-3059
Phone 21539941281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05544700NJMDClinical Social Worker
CW021098PAMDClinical Social Worker

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": "1385942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1285065235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 EAST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271805",
            "telephone_number": "215-436-9222",
            "fax_number": "856-541-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 EAST ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191271805",
            "telephone_number": "215-436-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILEY",
        "first_name": "TARA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-02",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05544700",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW021098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.