Laura Tanner, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

56600 Issued in TX

Practice address

2010 Ben Merritt Dr Unit a
Decatur, TX 76234-3853

Phone

(940) 626-2300

Fax

(940) 626-2543

NPI assigned

Feb 25, 2022

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Unraveled Therapy

  dba n/a

  • Adult Mental Health Clinic/Center
  • Decatur, TX
  • NPI 1275379216
  NPD Authorized official
• Wise Clinical Care Associates

  • Urgent Care Clinic/Center
  • Haslet, TX
  • NPI 1386112506
  NPD (past)

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

{
    "created_epoch": "1645747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1679229959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762346156",
            "telephone_number": "940-626-2300",
            "fax_number": "940-626-2315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 BEN MERRITT DR UNIT A",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343853",
            "telephone_number": "940-626-2300",
            "fax_number": "940-626-2543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "LAURA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-25",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679229959",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8RG827",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Swofford, FNP-C
• Amy Swoyer, M.S. CCC-SLP
• Jessica L Szatko, APRN
• Marilyn Tabanian, RN
• Tad Montgomery, Inc.
• Levi James Tate, D.C.
• Miranda Taylor, LVN
• TC Diagnostics LLC
• Teresa N. Hill, M.D., P.a.
• Texas Elite Therapy & Lymphatics PLLC

• Clinical Social Worker in Decatur, TX
• Providers in Decatur, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.