Healthcare Provider Details

I. General information

NPI: 1639677552
Provider Name (Legal Business Name): TARA DALE BUEHRER LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2018
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 E WASHINGTON ST
NAPOLEON OH
43545-1698
US

IV. Provider business mailing address

219 E WASHINGTON ST
NAPOLEON OH
43545-1698
US

V. Phone/Fax

Practice location:
  • Phone: 419-592-0540
  • Fax:
Mailing address:
  • Phone: 419-592-0540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI.2203535-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: