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

Tara Ann Bungum, LICSW

Individual provider Clinical Social Worker · NPI 1548065873

Tara Ann Bungum, LICSW is a Clinical Social Worker in Minnetonka, Minnesota. Licensed in Minnesota. Registered with an NPI since 2025.

Licensed in
MN
In the registry since
2025
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

3395 Plymouth Rd
Minnetonka, MN 55305-3765
Phone: (952) 939-0396
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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 30714 (MN)

Record details

NPI number1548065873
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorNo
NPI enumeratedFebruary 19, 2025
Last updated in NPPESFebruary 19, 2025
Certification dateFebruary 19, 2025

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