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General NPI Number Information
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NPI Number | 1700015583
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Entity Type | Individual
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Provider Name | TARA LINSLEY LMHC, MCAP, CIP
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Gender | Female
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Dates
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Enumeration Date | 07/14/2009
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 602 W. INDIAN RIVER BLVD STE 2
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City | EDGEWATER
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State | FL
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Zip | 32132
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Country | US
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Telephone | 386-245-8662
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Fax |
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Provider Business Mailing Address
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Address Line | 602 W INDIAN RIVER BLVD STE 2
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City | EDGEWATER
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State | FL
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Zip | 32132-3500
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Country | US
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Telephone | 386-245-8662
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC005631
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License Number State | GA
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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 | MH12101
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License Number State | FL
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