Terry Lynn Tackett, MSW/LCSW/LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C008655 Issued in NC

Practice address

610 S College Rd
Wilmington, NC 28403-3202

Phone

(910) 799-1071

Fax

(910) 799-3313

NPI assigned

Oct 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carenet IncGroup PAC ID 6406845262, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Carenet, Inc.

  • Mental Health Counselor
  • Winston Salem, NC
  • NPI 1043424013
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1396829164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033202",
            "telephone_number": "910-799-1071",
            "fax_number": "910-799-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S COLLEGE RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284033202",
            "telephone_number": "910-799-1071",
            "fax_number": "910-799-3313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "TERRY",
        "middle_name": "LYNN",
        "name_prefix": "Mr.",
        "credential": "MSW/LCSW/LISW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904003021",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C008655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synergy Homecare of Wilmington
• Synergy Wellness Center
• Laszlo Jozsef Szabo, M.D.
• Tara Ann Szczesny McKinney, MD
• Jillian Nicole Tabak, MSW, LCSW, LCAS
• Sylvia G Taggart, CRNA
• Erika Suzanne Tagliaferro, COTA/L
• Perla Rosanyi Talavera, LCMHC
• Karen A Talbert, PA-C
• Katelin Raye Talbert, PA-C

• Clinical Social Worker in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.