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
Mailing address745 36th Ave Ne, Minneapolis, MN 55418-1239

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