Individual provider · Type 1 NPI
Tara M. Prom, LICSW
Clinical Social Worker · St. Cloud, MN
Practice location
22 Wilson Ave NE Suite 110, PO Box 6069
St. Cloud, MN 56302-6069
Fax (320) 251-8898
Mailing address
1114 Somerset Blvd
St. Cloud, MN 56303-0750
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | 17338 (MN) |
| School Counselor | 101YS0200X | 429597 (MN) |
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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- Katherine Carol Logeais Hissam, LICSWClinical Social Worker St. Cloud, MN NPI 1033742119
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About NPI 1205338969
Tara M. Prom, LICSW's National Provider Identifier is 1205338969, issued on Mar 8, 2018. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in St. Cloud, MN. The record was last updated on Mar 8, 2018.