Provider Demographics
NPI:1336694777
Name:CHASE, TARYN (MA, LPC, LCADC, NCC)
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:MA, LPC, LCADC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 SCOTCH RD STE E
Mailing Address - Street 2:
Mailing Address - City:EWING
Mailing Address - State:NJ
Mailing Address - Zip Code:08628-2529
Mailing Address - Country:US
Mailing Address - Phone:609-403-6359
Mailing Address - Fax:609-403-9488
Practice Address - Street 1:20 SCOTCH RD STE E
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-2529
Practice Address - Country:US
Practice Address - Phone:609-403-6359
Practice Address - Fax:609-403-9488
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00304100101YA0400X
NJ37PC00644000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)