Tara Misra, MS, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

A12635 Issued in OR

Practice address

1235 SE Division St
Portland, OR 97202-1099

Phone

(360) 726-4141

NPI assigned

Jul 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 18, 2026 through May 18, 2028

Specialty

Clinical Social Worker

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Roots Therapy NW LLC

  • Mental Health Counselor
  • Portland, OR
  • NPI 1831789098

  Clinical

  NPD

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1417620154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 SE 40TH AVE APT 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972024091",
            "telephone_number": "505-620-1692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SE DIVISION ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021099",
            "telephone_number": "360-726-4141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISRA",
        "first_name": "TARA",
        "credential": "MS, MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "A12635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colin Scott Misich
• Cami Misk, LPC
• Sara Misner
• Sahana Misra, M.D.
• Sounak N Misra, MD
• John Frederic Mission, M.D.
• Mississippi Chiropractic, P.C.
• Mississippi Health Center Medicinay LLC
• Scott David Mist, MACOM, PHD
• Kiran Mistry, D.D.S.

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• 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.