MEDICARE: TARA CROWL 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
1	101YP2500X	Professional Counselor	3177	KS

General Provider Information

NPI Number	:	1740793967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA CROWL LPC

Provider Business Mailing Address
First Line	:	4050 PENNSYLVANIA AVE STE 115 #25
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3041
Country	:	US
Telephone Number	:	816-866-8380
Fax Number	:

Provider Business Practice Location Address
First Line	:	8232 NW WAUKOMIS DR
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64151-1038
Country	:	US
Telephone Number	:	816-866-8380
Fax Number	:

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

Provider Enumeration Date	:	11/09/2017
Last Update Date	:	09/27/2021

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Directions to “ TARA CROWL LPC” Practice Location

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