Tara Lynn Thackeray, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5863800-3501 Issued in UT

Practice address

1031 S Bluff St Ste 225
St George, UT 84770-5206

Phone

(435) 899-9668

NPI assigned

Aug 27, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tara Lynn Gloshen Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1962179754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 S BLUFF ST STE 225",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705206",
            "telephone_number": "435-899-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 S BLUFF ST STE 225",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847705206",
            "telephone_number": "435-899-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKERAY",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "5863800-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "SimplePractice",
            "affiliation": "N",
            "endpointDescription": "Therapy notes/billing platform",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Therapy Diagnosis",
            "address_1": "1031 S Bluff St Ste 225",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847705206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "GLOSHEN",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Megan Thacker
• Verne Gerald Thamert Jr., LCSW
• Vishant Thapa, DNP-FNP
• The Children's Vision Center LLC
• The Chiropractic Avenue (Balanced Spinal Care)
• The Foot & Ankle Institute LLC

• Clinical Social Worker in St George, UT
• Providers in St George, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.