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NPI Code Detail

MEDICARE: MS. TARA CAYE HERNANDEZ MSW

MEDICARE: MS. TARA CAYE HERNANDEZ MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker1823-MAR
21041C0700XClinical Social Worker2282-CAR

General Provider Information

NPI Number : 1568565521
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TARA CAYE HERNANDEZ MSW
Provider Business Mailing Address
First Line : PO BOX 15968
Second Line :
City : LITTLE ROCK
State : AR
Zip : 72231-5968
Country : US
Telephone Number : 501-221-1843
Fax Number : 501-221-2376
Provider Business Practice Location Address
First Line : 4354 STOCKTON DR
Second Line :
City : NORTH LITTLE ROCK
State : AR
Zip : 72117-2917
Country : US
Telephone Number : 501-955-7600
Fax Number : 501-955-7612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 08/27/2009

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