Jacque Lynn Tague, LMSW, LAC

Primary specialty

Social WorkerTaxonomy code 104100000X

License

7528 Issued in KS

Practice address

555 N Woodlawn St Ste 102
3105
Wichita, KS 67208-3671

Phone

(316) 652-2590

Fax

(316) 652-2595

NPI assigned

Jan 31, 2011

Last updated

Dec 6, 2013By the provider in NPPES

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 identifiers 1

Other names 1

• Ms. Jacque Lynn Tague Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mental Health America of South Central Kansas, Inc.

  • Community/Behavioral Health Agency
  • Wichita, KS
  • NPI 1689710568
  NPD (past)

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

{
    "created_epoch": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1770889354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 N WOODLAWN ST STE 102",
            "address_2": "3105",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083671",
            "telephone_number": "316-652-2590",
            "fax_number": "316-652-2595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 N WOODLAWN ST STE 102",
            "address_2": "3105",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083671",
            "telephone_number": "316-652-2590",
            "fax_number": "316-652-2595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGUE",
        "first_name": "JACQUE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LMSW, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KS",
            "license": "378",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "7528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200714670A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUE",
            "last_name": "TAGUE",
            "middle_name": "LYNN",
            "prefix": "MS.",
            "credential": "LMSW, LAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mackenzie Marie Tade
• Kimberly M Tadtman, RD, LD
• Camarra Tafesse, LMSW
• Christa Taft, LAC
• Tag Treatment Center LLC (Therapeutic Alliance Group)
• Mansoor Ahmed Tahir, P.A.-C
• Casey Sean Tajchman, RPT
• Cecilia Talamantes
• Isaac Clayton Talbert, MD
• Megan Talbert

• Social Worker in Wichita, KS
• Providers in Wichita, KS by specialty
• Social Worker in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.