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General NPI Number Information
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NPI Number | 1427550219
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Entity Type | Individual
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Provider Name | TARA R PEREZ LPCC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2018
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 1832 BALTIMORE RD NW
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City | LANCASTER
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State | OH
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Zip | 43130-8212
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Country | US
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Telephone | 740-438-6379
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Fax |
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Provider Business Mailing Address
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Address Line | 65 MESSIMER DR
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City | NEWARK
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State | OH
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Zip | 43055-1874
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Country | US
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Telephone | 740-438-6379
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | E.2404463
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH22992
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License Number State | FL
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