Tara Devineni LCSW LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

CW019653 Issued in PA

Legal business name

TARA DEVINENI LCSW LLC

Practice address

1137 Lancaster Ave
Berwyn, PA 19312-1243

Phone

(484) 424-7218

NPI assigned

Dec 14, 2017

Last updated

Dec 14, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tara Devineni, LCSWNPI 1568872240

Title

Licensed Clinical Social Worker

Phone

(484) 424-7218

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tara Devineni, LCSW

  • Clinical Social Worker
  • Berwyn, PA
  • NPI 1568872240
  NPD (past) Authorized official

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

{
    "created_epoch": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513209600000",
    "number": "1871008706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 LANCASTER AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121243",
            "telephone_number": "484-424-7218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 LANCASTER AVE",
            "city": "BERWYN",
            "state": "PA",
            "postal_code": "193121243",
            "telephone_number": "484-424-7218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARA DEVINENI LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2017-12-14",
        "status": "A",
        "authorized_official_last_name": "DEVINENI",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "484-424-7218",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "PA",
            "license": "CW019653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Marie Specht, MSN, RN, PMHCNS-BC
• Candace C Stevens
• Lindsay Stotts, MS, SLP
• Surrey Services for Seniors
• Synergy Psychological Associates, LLC
• David M Taylor, D.M.D
• The Berwyn Fire Company (Berwyn Fire Company)
• The Devereux Foundation
• The Devereux Foundation
• The Devereux Foundation

• Adult Mental Health Clinic/Center in Berwyn, PA
• Providers in Berwyn, PA by specialty
• Adult Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.