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NPI Code Detail

MEDICARE: ANDREW TARR LPC

MEDICARE:   ANDREW  TARR  LPC
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
1101YM0800XMental Health Counselor1500680OH

General Provider Information

NPI Number : 1225557028
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW TARR LPC
Provider Business Mailing Address
First Line : 7522 CRANSTON CT APT C
Second Line :
City : NORTH ROYALTON
State : OH
Zip : 44133-6818
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5955 RIDGE RD
Second Line :
City : PARMA
State : OH
Zip : 44129-3936
Country : US
Telephone Number : 440-888-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2017
Last Update Date : 09/12/2017

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