Tara Durkin, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016626 Issued in PA

Practice address

5100 Peach St
Erie, PA 16509-2482

Phone

(814) 866-4500

Fax

(814) 864-2677

NPI assigned

Mar 26, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Tara Shoop Former name

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

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351468800000",
    "number": "1750605283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092482",
            "telephone_number": "814-866-4500",
            "fax_number": "814-864-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 PEACH ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165092482",
            "telephone_number": "814-866-4500",
            "fax_number": "814-864-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURKIN",
        "first_name": "TARA",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-26",
        "last_updated": "2012-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW124363",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "SHOOP",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• John Phillip Dupaix, M.D.
• Andres Bryant Duran, M.D.
• Amy Durie, MSSW, LCSW
• Christina Marie Duris
• Angela Durkin, DC
• Tracey Ann Durkin, MA, LPC, NCC
• Matthew G Durney
• Sallie Dusckas
• Zachary Dusckas, M.D.
• Dva Healthcare Renal Care Inc

• Clinical Social Worker in Erie, PA
• Providers in Erie, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.