MEDICARE: MRS. TARA PISTORIO LCPC, CAC-AD

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	AC1649	MD
2	101YM0800X	Mental Health Counselor	LC9296	MD

General Provider Information

NPI Number	:	1760087837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TARA PISTORIO LCPC, CAC-AD

Provider Business Mailing Address
First Line	:	4 BRAMBLE LN
Second Line	:
City	:	CHURCHVILLE
State	:	MD
Zip	:	21028-1505
Country	:	US
Telephone Number	:	410-207-2509
Fax Number	:

Provider Business Practice Location Address
First Line	:	8600 LASALLE RD.
Second Line	:	CARROLL BUILDING, SUITE 212
City	:	TOWSON
State	:	MD
Zip	:	21286-2128
Country	:	US
Telephone Number	:	410-773-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/04/2020
Last Update Date	:	12/04/2020

Similar Medicare Providers

1316536386 — CRYSANNIA ANDREWS
Practice Location Address:

8501 LASALLE RD , SUITE 115
TOWSON, MD
21286-2128

Practice Phone: 410-337-7772
Practice Fax:

1801674650 — FREAS SPEECH THERAPY
Practice Location Address:

320 EAST TOWSONTOWN BLVD , TERRACE LEVEL
TOWSON, MD
21286-2128

Practice Phone: 410-424-5946
Practice Fax: 410-769-0602

1649120312 — BRIANA CICCARINO LMSW
Practice Location Address:

1220 E JOPPA RD
TOWSON, MD
21286-5811

Practice Phone: 410-449-4955
Practice Fax:

1730545773 — MS. ERICA MONIQUE COOK LCSW-C
Practice Location Address:

8600 LA SALLE RD , SUITE 300, CHESTER BUILDING
TOWSON, MD
21286-2001

Practice Phone: 410-494-9212
Practice Fax: 410-494-9217

1013910454 — DR. DAVID S. BERLINER M.D.
Practice Location Address:

515 FAIRMOUNT AVE , STE 400
TOWSON, MD
21286-5466

Practice Phone: 410-494-1397
Practice Fax: 410-584-2247

1265436810 — HOLLY HILL MANOR INC.
Practice Location Address:

531 STEVENSON LN
TOWSON, MD
21286-7607

Practice Phone: 410-823-5310
Practice Fax: 410-583-8148

Directions to “ MRS. TARA PISTORIO LCPC, CAC-AD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.