Tara Smith, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW80402 Issued in CA

Practice address

684 W Boughton Rd Ste D
Bolingbrook, IL 60440-1781

Phone

(773) 688-4568

NPI assigned

Oct 3, 2017

Last updated

Feb 6, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tara Smith Martinez Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Well Being Collective, a Licensed Clinical Social Worker Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sacramento, CA
  • NPI 1073451118
  NPD Authorized official

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1841700036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8549 WILSHIRE BLVD UNIT 3356",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902113104",
            "telephone_number": "323-510-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 W BOUGHTON RD STE D",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401781",
            "telephone_number": "773-688-4568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "TARA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-03",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.019343",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW80402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "SMITH MARTINEZ",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Donrita Smith, CCC-SLP/L
• Karyn Smith
• Lateena Smith, EDS
• Latrina Smith, LCSW
• Sarah Catherine Smith, M.P.T.
• Tara E Smith, PT
• William Kelvyn Smith, ED.D.
• Gina Marie Smoger, RDH
• Sneha Naik DDS PLLC (City Family Dental)
• Bao Ling Pauline Soh

• Clinical Social Worker in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.