Individual provider Active NPI

Tara Pauley, MSW

  • Clinical Social Worker
  • Grand Blanc, MI
National Provider Identifier
1285084921
Registry record updated Jun 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801094629 Issued in MI
Practice address
8435 Holly Rd
Grand Blanc, MI 48439-1812
Phone
(810) 603-8800
Fax
(810) 579-7222
NPI assigned
Jun 14, 2016
Last updated
Jun 14, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 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 6801094629 MI Primary

Addresses

Primary practice location

8435 Holly Rd
Grand Blanc, MI 48439-1812

Mailing address

3495 S Center Rd
Burton, MI 48519-1455
Phone (810) 424-2011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160701001507 MI Practitioner - Clinical Social Worker 1557653094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Emotional Wellness PLLCGroup PAC ID 1052760725, 6 clinicians

Practice addresses (Care Compare)

9082 Davison Rd
Davison, MI 48423-1037
Phone (810) 620-1518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Emotional Wellness, PLLC Clinical CurrentSince Oct 14, 2023 Accepting new patients
Dailey Life, Inc. PastSince Oct 14, 2023 Accepting new patients
Genesys Practice Partners, Inc. Past Accepting new patients

Locations

9082 Davison Rd
Davison, MI 48423
Phone (810) 620-1518

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1285084921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 S CENTER RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485191455",
            "telephone_number": "810-424-2011",
            "fax_number": "810-249-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8435 HOLLY RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391812",
            "telephone_number": "810-603-8800",
            "fax_number": "810-579-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULEY",
        "first_name": "TARA",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801094629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

Verify at the official NPI Registry.