Healthcare Provider Details

I. General information

NPI: 1427281898
Provider Name (Legal Business Name): TARA JANE UNDERWOOD-LEVIN PSY.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 E MAIN ST PO BOX 418
SOLON IA
52333
US

IV. Provider business mailing address

102 E MAIN ST PO BOX 418
SOLON IA
52333
US

V. Phone/Fax

Practice location:
  • Phone: 319-541-0412
  • Fax: 319-409-9424
Mailing address:
  • Phone: 319-541-0412
  • Fax: 319-409-9424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number001112
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number001112
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: