Healthcare Provider Details

I. General information

NPI: 1376690040
Provider Name (Legal Business Name): TARA ANN BARNARD LICSW, MSW, SUDP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2326 RUCKER AVE STE 202
EVERETT WA
98201-2723
US

IV. Provider business mailing address

2326 RUCKER AVE STE 202
EVERETT WA
98201-2723
US

V. Phone/Fax

Practice location:
  • Phone: 360-516-2272
  • Fax:
Mailing address:
  • Phone: 360-516-2272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP00006385
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLW60296110
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60296110
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: