Tara Ammersen, LCSW
Individual provider Active NPI Social Worker · Oswego, NY
NPI 1306132691 · NPPES record last updated Sep 10, 2018
Key facts
- NPI
- 1306132691
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 083530-1 (NY)
- Practice address
- 74 Bunner St
Oswego, NY 13126-3357 - Phone
- (315) 326-4167
- NPI assigned
- Jun 24, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 083530-1 | NY | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 083530-1 | NY | Yes |
Addresses
Primary practice location
74 Bunner St
Oswego, NY 13126-3357
Mailing address
572 S Salina St
Syracuse, NY 13202-3320
Phone (315) 350-0192
Other providers in Oswego, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.