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NPI Code Detail

MEDICARE: MS. TARA MICHELLE HINDS LCPC

MEDICARE:  MS. TARA MICHELLE HINDS  LCPC
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
1101Y00000XCounselor178009025IL
2101YP2500XProfessional Counselor180010280IL

General Provider Information

NPI Number : 1962869172
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TARA MICHELLE HINDS LCPC
Provider Business Mailing Address
First Line : 2265 W 113TH PL
Second Line :
City : CHICAGO
State : IL
Zip : 60643-4104
Country : US
Telephone Number : 773-683-3500
Fax Number :
Provider Business Practice Location Address
First Line : 2265 W 113TH PL
Second Line :
City : CHICAGO
State : IL
Zip : 60643-4104
Country : US
Telephone Number : 773-683-3500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2016
Last Update Date : 06/18/2024

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Directions to “ MS. TARA MICHELLE HINDS LCPC” Practice Location

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