Individual provider · Type 1 NPI

Tara Alisabeth Bagnola

Clinical Social Worker · Glencoe, IL

NPI number 1104568021 Active

Practice location

361 Park Ave
Glencoe, IL 60022-1587

Call (773) 828-0127 Map

Mailing address

2535 N Hamlin Ave
Chicago, IL 60647-1007

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000XNone listed
Clinical Social Worker Primary 1041C0700X149026008 (IL)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1104568021

Tara Alisabeth Bagnola's National Provider Identifier is 1104568021, issued on Apr 11, 2022. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Glencoe, IL. The record was last updated on Oct 19, 2023.