Provider Demographics
NPI:1417799636
Name:GUSS, TARA J (LMSW)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:J
Last Name:GUSS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:JEANNETTE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12833 S SEMINOLE DR
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-1403
Mailing Address - Country:US
Mailing Address - Phone:913-594-2454
Mailing Address - Fax:
Practice Address - Street 1:12833 S SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66062-1403
Practice Address - Country:US
Practice Address - Phone:913-594-2454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12626104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker