Provider Demographics
NPI:1043258981
Name:NOID, TARA J (LPC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:J
Last Name:NOID
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-0553
Mailing Address - Country:US
Mailing Address - Phone:828-423-3949
Mailing Address - Fax:888-423-5250
Practice Address - Street 1:900 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 306
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1734
Practice Address - Country:US
Practice Address - Phone:828-423-3949
Practice Address - Fax:828-423-5250
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3841101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6102108Medicaid