Individual provider Active NPI

Tara Verduzco, LCSW

  • Clinical Social Worker
  • Indianapolis, IN
National Provider Identifier
1699248211
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007385A Issued in IN
Practice address
3815 River Crossing Pkwy Ste 100
Indianapolis, IN 46240-7766
Phone
(646) 941-7645
Fax
(929) 596-7897
NPI assigned
Jan 7, 2019
Last updated
May 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X 34007385A IN Primary

Addresses

Primary practice location

3815 River Crossing Pkwy Ste 100
Indianapolis, IN 46240-7766

Mailing address

333 N Alabama St
Indianapolis, IN 46204-2034
Phone (323) 205-7088

Other practice location 1

333 N Alabama St
Indianapolis, IN 46204-2034
Phone (323) 205-7088

Other identifiers 2

IdentifierTypeStateIssuer
1699248211MedicaidIN
1699248211OtherINPRIVATE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20190121000572 IN Practitioner - Clinical Social Worker 1355688979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nwi Clarity ClinicGroup PAC ID 5991082976, 32 clinicians

Practice addresses (Care Compare)

9250 Columbia Ave
Suite 2E
Munster, IN 46321-3530
Phone (219) 595-0043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nwi Clarity Clinic Clinical CurrentSince Jan 1, 2026 Accepting new patients

Locations

9250 Columbia Ave
Ste 2E
Munster, IN 46321
Phone (219) 595-0043

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1699248211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N ALABAMA ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462042034",
            "telephone_number": "323-205-7088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3815 RIVER CROSSING PKWY STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462407766",
            "telephone_number": "646-941-7645",
            "fax_number": "929-596-7897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 N Alabama St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462042034",
            "country_code": "US",
            "telephone_number": "323-205-7088",
            "fax_number": "833-419-0181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VERDUZCO",
        "first_name": "TARA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007385A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699248211",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE",
            "identifier": "1699248211",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.