Tara L Shirek, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2922

Practice address

735 Hill Ave
Suite 203
Grafton, ND 58237

Phone

(701) 746-8376

Fax

(701) 746-9872

NPI assigned

May 25, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ND

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lipp Carlson Witucki and Associates LTDGroup PAC ID 2062408701, 10 clinicians

Pembina County Memorial Hospital AssociationGroup PAC ID 4789643719, shared by 4 NPIs, 142 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Lipp, Carlson, Witucki & Associates, LTD

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1043316961
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1407067994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 17TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-746-8376",
            "fax_number": "701-746-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 HILL AVE",
            "address_2": "SUITE 203",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "58237",
            "telephone_number": "701-746-8376",
            "fax_number": "701-746-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIREK",
        "first_name": "TARA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "2922",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "2922",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": "2922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1456289",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen R Schweitzer, FNP-BC
• Marlys Severson
• Christi Lynn Shadow, LSW
• Jody Rae Sharp, NP-C
• Jennifer D Shaw, M.D.
• Skin Rehab PLLC
• Youssef N Solomon, M.D.
• Angela Faith Solseng, OT
• Kristin Stewart
• Amy Lynn Suda, FNP-C

• Clinical Social Worker in Grafton, ND
• Providers in Grafton, ND by specialty
• Clinical Social Worker in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.