MEDICARE: TARA ALISON MAHANEY LACROSS M.A., CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1043537269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA ALISON MAHANEY LACROSS M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	8640 CARLSBAD LN
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-5807
Country	:	US
Telephone Number	:	517-282-2281
Fax Number	:

Provider Business Practice Location Address
First Line	:	616 S CREYTS RD STE B
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48917-8269
Country	:	US
Telephone Number	:	517-258-7889
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2010
Last Update Date	:	12/02/2025

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Directions to “ TARA ALISON MAHANEY LACROSS M.A., CCC-SLP” Practice Location

Language	Start Address	Practice Location

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