Healthcare Provider Details
I. General information
NPI: 1144745977
Provider Name (Legal Business Name): TARA HOGAN SCARBOROUGH PSY. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
COUNSELING AND PSYCHOLOGICAL SERVICES UNIVERSITY OF CINCINNATI, 225 CALHOUN STREET, SUITE 200
CINCINNATI OH
45219
US
IV. Provider business mailing address
225 CALHOUN STREET, SUITE 200, MAIL LOC 0034
CINCINNATI OH
45219
US
V. Phone/Fax
- Phone: 513-556-0648
- Fax: 513-556-2302
- Phone: 513-556-0648
- Fax: 513-556-2302
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TF0000X |
| Taxonomy | Family Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TH0100X |
| Taxonomy | Health Service Psychologist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC1900X |
| Taxonomy | Counseling Psychologist |
| License Number | 6315 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: