Tara Ann Perttula, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801096893 Issued in MI

Practice address

16180 Hastings Ave SE
Prior Lake, MN 55372

Phone

(952) 443-4600

Fax

(952) 443-4604

NPI assigned

Aug 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Collaborative Counseling LLCGroup PAC ID 3678711900, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Collaborative Counseling LLC

  • Mental Health Counselor
  • Maple Grove, MN
  • NPI 1598034324
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1408492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530057600000",
    "number": "1780083287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16180 HASTINGS AVE SE STE 205",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553729228",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16180 HASTINGS AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "55372",
            "telephone_number": "952-443-4600",
            "fax_number": "952-443-4604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "791 Chambers Rd",
            "address_2": "Suite 411",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800117112",
            "country_code": "US",
            "telephone_number": "303-617-2773",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERTTULA",
        "first_name": "TARA",
        "middle_name": "ANN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-20",
        "last_updated": "2018-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801096893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Grace Patton, PA-C
• PDG,P.a.
• Pearla LLC
• Kerri Penke
• Elizabeth Penshorn, DPT
• Helen Jane Peterson, CNP
• Matthew Steven Pivec, PHARM.D.
• Pivotal Family Chiropractic LLC
• Katherine Price, OTR/L
• Prior Lake

• Social Worker in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.