Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tara Waldron, LICSW

Individual provider Clinical Social Worker · NPI 1750723573

Tara Waldron, LICSW is a Clinical Social Worker in Blaine, Minnesota. Licensed in Minnesota. Registered with an NPI since 2013.

Licensed in
MN
In the registry since
2013
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

11870 Ulysses St NE Ste 200
Blaine, MN 55434-4179
Phone: (763) 482-9598
Fax: (612) 235-6447
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 20530 (MN)

Record details

NPI number1750723573
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedJuly 22, 2013
Last updated in NPPESJuly 22, 2013

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