Provider Demographics
NPI:1164451076
Name:AYERS, TARA S (LPC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:S
Last Name:AYERS
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 1:1720 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-7285
Mailing Address - Country:US
Mailing Address - Phone:336-878-6226
Mailing Address - Fax:336-878-6272
Practice Address - Street 1:320 BOULEVARD ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3802
Practice Address - Country:US
Practice Address - Phone:336-878-6226
Practice Address - Fax:336-878-6272
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1416KOtherBCBS
NC6103052Medicaid