Taresa Janelle Spade, LCSW is a
Social Worker - Clinical based in Clinton, Montana. Taresa Janelle Spade is licensed to practice in Montana (license number BBH-LCSW-LIC-42656) and her current practice location is
12508 Hawk Ln, Clinton, Montana. She can be reached at her office (for appointments etc.) via phone at
(808) 359-4730.
NPI number for Taresa Janelle Spade is 1063031557 and her current mailing address is 1522 E Shore Dr, Detroit Lakes, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1063031557.
Healthcare Provider's Profile
| Full Name | Taresa Janelle Spade |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 12508 Hawk Ln, Clinton, Montana |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1063031557
- Provider Enumeration Date: 04/14/2020
- Last Update Date: 04/02/2026
Medical Identifiers
Medical identifiers for Taresa Janelle Spade such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1063031557 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | LCSW-4493 (Hawaii) | Secondary |
| 1041C0700X | Social Worker - Clinical | 31664 (Minnesota) | Secondary |
| 1041C0700X | Social Worker - Clinical | 15379 (Oregon) | Secondary |
| 1041C0700X | Social Worker - Clinical | 101117 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 61317222 (Washington) | Secondary |
| 1041C0700X | Social Worker - Clinical | BBH-LCSW-LIC-42656 (Montana) | Primary |
| 1041C0700X | Social Worker - Clinical | 149.026956 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Taresa Janelle Spade is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Taresa Janelle Spade, LCSW 1522 E Shore Dr, Detroit Lakes, MN 56501-4707 Ph: (808) 359-4730 | Taresa Janelle Spade, LCSW 12508 Hawk Ln, Clinton, MT 59825-9033 Ph: (808) 359-4730 |
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