Search › Maryland › 104100000X
Tara Stack, MSW, LCSW-C
NPI 1417354523 · on the registry since 2014 · sole proprietor
Practice
- Address
- 16701 Melford Blvd Ste 400
Bowie, MD 20715 - Phone
- (415) 424-4266
- Fax
- (415) 520-6633
- Organisation at this address
- Dtg Ii Pllc
Mindfull Llc
Medicomp Inc
Woundworx Llc
Urban TherapyInferred from a shared address, not stated in the registry. - Clinicians at this address
- 62
Additional practice sites
- 11202 Kent Ct, New Market, MD
- 111 W Jackson Blvd Ste 1700, Chicago, IL
Registry record
- Primary taxonomy
- 104100000X
104100000X
- Also registered as
- 1041C0700X
- Licence states on file
- IL, MD
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-12-12
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Maryland