Individual provider Active NPI

Tara L Snell-Kooken, MSW, LCSW

  • Clinical Social Worker
  • Bloomsburg, PA
National Provider Identifier
1689921348
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW017679 Issued in PA
Practice address
549 Fair St
Bloomsburg, PA 17815-1419
Phone
(570) 271-6396
NPI assigned
Aug 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW127548 PA
Clinical Social Worker 1041C0700X CW017679 PA Primary

Addresses

Primary practice location

549 Fair St
Bloomsburg, PA 17815-1419

Mailing address

320 Highland Dr
P.O. Box 597
Mountville, PA 17554-1232
Phone (717) 285-7121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20130703000097 PA Practitioner - Clinical Social Worker 5597905141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

549 Fair St
Bloomsburg, PA 17815-1419
Phone (570) 387-2251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW127548PAMDSocial Worker
CW017679PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Aug 3, 2020 Accepting new patients
Geisinger Clinic CurrentSince Aug 3, 2020 Accepting new patients

Locations

549 Fair St
Bloomsburg, PA 17815
Phone (570) 387-2100

100 N Academy Ave
Danville, PA 17822

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1344729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1689921348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 HIGHLAND DR",
            "address_2": "P.O. BOX 597",
            "city": "MOUNTVILLE",
            "state": "PA",
            "postal_code": "175541232",
            "telephone_number": "717-285-7121",
            "fax_number": "717-285-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 FAIR ST",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178151419",
            "telephone_number": "570-271-6396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNELL-KOOKEN",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-12",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW127548",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

Verify at the official NPI Registry.