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NPI Code Detail

MEDICARE: TARYN CHASE MA, LPC, LCADC, NCC

MEDICARE: TARYN CHASE MA, LPC, LCADC, NCC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor37LC00304100NJ
2101YP2500XProfessional Counselor37PC00644000NJ

General Provider Information

NPI Number : 1336694777
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARYN CHASE MA, LPC, LCADC, NCC
Provider Business Mailing Address
First Line : 20 SCOTCH RD STE E
Second Line :
City : EWING
State : NJ
Zip : 08628-2529
Country : US
Telephone Number : 609-403-6359
Fax Number : 609-403-9488
Provider Business Practice Location Address
First Line : 20 SCOTCH RD STE E
Second Line :
City : EWING
State : NJ
Zip : 08628-2529
Country : US
Telephone Number : 609-403-6359
Fax Number : 609-403-9488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2016
Last Update Date : 07/27/2021

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