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Physician Compare National (NPI:1467687913)

HEALTHCARE PROVIDER: TARA BLURY MSW, LMSW, TF-CBT

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1467687913
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2769704204
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20141211001127
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BLURY
Individual professional last name
Provider First Name TARA
Individual professional first name
Provider Middle Name M
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2009
Individual professional's medical school graduation year
Primary Specialty CLINICAL SOCIAL WORKER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 9809 CHERRY VALLEY AVE SE H
Group Practice or individual's line 1 address
City CALEDONIA
Group Practice or individual's city
State MI
Group Practice or individual's state
Zip Code 493169592
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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