Tara Anne Coppola, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003058 Issued in GA

Practice address

4006 Holcomb Bridge Rd Ste 210
Peachtree Corners, GA 30092-1814

Phone

(678) 444-4505

Fax

(678) 606-9316

NPI assigned

Sep 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Counseling Services of Atlanta LLCGroup PAC ID 8820438716, 15 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Counseling Services of Atlanta, LLC

  • Professional Counselor
  • Marietta, GA
  • NPI 1508271024
  Medicare reassignment Care Compare group NPD
• Tara Coppola LCSW Inc

  • Clinical Social Worker
  • Alpharetta, GA
  • NPI 1861650996
  Authorized official Same address or phone

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1952409294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 DEER CREEK LN",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306556273",
            "telephone_number": "678-488-1476",
            "fax_number": "678-606-9316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 HOLCOMB BRIDGE RD STE 210",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300921814",
            "telephone_number": "678-444-4505",
            "fax_number": "678-606-9316"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "370 Prospect Pl",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300055467",
            "country_code": "US",
            "telephone_number": "678-488-1476",
            "fax_number": "678-608-3827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "TARA",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003058",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233399379A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Octavia Collie
• Lady Carolina Collins, CPNP-PC
• Connect Grow Thrive LLC
• Terri Conner, BCBA BEHAVIORANALYST
• Lisa Connor, CNM
• Kazia Cortel-Fraser
• Lisa Marie Crandall, FNP
• Lakeysha Crawford
• Cruz Co Services Inc
• Jillian Cuchna

• Clinical Social Worker in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.