Provider Demographics
NPI:1457514606
Name:DOWNS, TARA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:
Last Name:DOWNS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WOLVERINE CT
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-6813
Mailing Address - Country:US
Mailing Address - Phone:615-419-8443
Mailing Address - Fax:
Practice Address - Street 1:1830 HERITAGE PARK PLZ
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1575
Practice Address - Country:US
Practice Address - Phone:615-895-8104
Practice Address - Fax:615-895-7903
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3920123OtherMEDICARE