Tara Lucille Benegas
Individual provider Active NPI Clinical Social Worker · Frederick, CO
NPI 1811615610 · NPPES record last updated Aug 17, 2022
Key facts
- NPI
- 1811615610
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 0000000944 (CO)
- Practice address
- 6113 Easton Cir
Frederick, CO 80504-5968 - Phone
- (720) 331-1095
- NPI assigned
- Aug 17, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000000944 | CO | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 0000000944 | CO | Yes |
Addresses
Primary practice location
6113 Easton Cir
Frederick, CO 80504-5968
Mailing address
6113 Easton Cir
Frederick, CO 80504-5968
Phone (720) 331-1095
Other providers in Frederick, CO
- Rosario I Almiron
- Andrea Maria Auxier
- Michael Andrew Bagley
- Barbara E Barlow
- Jacey Wilemon Baxter
- Dustin Berg
- Jeffrey Berger
- Derrick Shilo Betting
- Abby Elizabeth Bohall
- Matthew Brady
All providers in Frederick, CO · Clinical Social Worker in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.