Individual provider Active NPI

Tara L Greer, LICSW

  • Clinical Social Worker
  • Mobile, AL
National Provider Identifier
1700210978
Registry record updated Oct 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4186C Issued in AL
Practice address
5750A Southland Dr
Mobile, AL 36693-3316
Phone
(251) 450-2211
Fax
(251) 662-7297
NPI assigned
Aug 23, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2018

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 116341 AK
Clinical Social Worker 1041C0700X 4186C AL Primary

Addresses

Primary practice location

5750A Southland Dr
Mobile, AL 36693-3316

Mailing address

5750A Southland Dr
Mobile, AL 36693-3316
Phone (251) 450-2211

Other identifiers 1

IdentifierTypeStateIssuer
MH2237MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
116341AKMDClinical Social Worker
4186CALMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539820800000",
    "number": "1700210978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750A SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933316",
            "telephone_number": "251-450-2211",
            "fax_number": "251-662-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5750A SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933316",
            "telephone_number": "251-450-2211",
            "fax_number": "251-662-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREER",
        "first_name": "TARA",
        "middle_name": "L",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-23",
        "last_updated": "2018-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "116341",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "4186C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH2237",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.