Tara Jean Wise, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

224518 Issued in MA

Practice address

1 Eaton PL
Worcester, MA 01608-1232

Phone

(508) 856-0732

Fax

(508) 425-5126

NPI assigned

Apr 1, 2020

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 names 1

• Tara J Chapdelaine Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: tara.wise.npi1972131100.reliant@direct.optumcare.masshiway.net

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1972131100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL STREET2",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-856-0732",
            "fax_number": "508-425-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EATON PL",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081232",
            "telephone_number": "508-856-0732",
            "fax_number": "508-425-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "TARA",
        "middle_name": "JEAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "224518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "CHAPDELAINE",
            "middle_name": "J",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dale Winters
• Nicholas Winters, PA-C
• Winthrop Apothecary, Inc.
• Jena Lois Wise, PA-C
• Sara Kaplen Wise, L.I.C.S.W.
• Jacab Wiseman
• Willow Wiseman
• Karen Wiss, M.D.
• Leona Withersallaire
• Alexis Witkower

• Clinical Social Worker in Worcester, MA
• Providers in Worcester, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.