Provider Demographics
NPI:1952708125
Name:ZANDI, TARA (LICSW)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:ZANDI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 QUINCY ST NW UNIT 3C
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5568
Mailing Address - Country:US
Mailing Address - Phone:508-414-6270
Mailing Address - Fax:
Practice Address - Street 1:1380 QUINCY ST NW UNIT 3C
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5568
Practice Address - Country:US
Practice Address - Phone:508-414-6270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD197131041C0700X
VA09040115661041C0700X
CA1087201041C0700X
DCLC500811731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical