Healthcare Provider Details

I. General information

NPI: 1700015583
Provider Name (Legal Business Name): TARA LINSLEY LMHC, MCAP, CIP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TARA CARTER LPC

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 W. INDIAN RIVER BLVD STE 2
EDGEWATER FL
32132
US

IV. Provider business mailing address

602 W INDIAN RIVER BLVD STE 2
EDGEWATER FL
32132-3500
US

V. Phone/Fax

Practice location:
  • Phone: 386-245-8662
  • Fax:
Mailing address:
  • Phone: 386-245-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC005631
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH12101
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: