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NPI Code Detail

MEDICARE: AUBREY TARR LPC

MEDICARE: AUBREY TARR LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor178014895IL

General Provider Information

NPI Number : 1427631365
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUBREY TARR LPC
Provider Business Mailing Address
First Line : 11150 SULPHUR SPRINGS RD
Second Line :
City : LOAMI
State : IL
Zip : 62661-3159
Country : US
Telephone Number : 217-691-4493
Fax Number :
Provider Business Practice Location Address
First Line : 2200 S 6TH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-3454
Country : US
Telephone Number : 217-698-7150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2021
Last Update Date : 04/29/2021

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