Provider Demographics
NPI:1003935578
Name:CARMODY, TARAH ELIZABETH RAE (MA LMFT)
Entity Type:Individual
Prefix:MS
First Name:TARAH
Middle Name:ELIZABETH RAE
Last Name:CARMODY
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Gender:F
Credentials:MA LMFT
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Mailing Address - Street 1:24979 CONSTITUTION AVE
Mailing Address - Street 2:APARTMENT 823
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1728
Mailing Address - Country:US
Mailing Address - Phone:310-909-6729
Mailing Address - Fax:661-362-1033
Practice Address - Street 1:28326 CONSTELLATION RD
Practice Address - Street 2:SUITE 205
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5078
Practice Address - Country:US
Practice Address - Phone:310-909-6729
Practice Address - Fax:661-362-1033
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2009-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA47208106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist