Provider Demographics
NPI:1376077917
Name:EHMANN, TARA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:
Last Name:EHMANN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:TARA
Other - Middle Name:C
Other - Last Name:EHMANN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:786 KING GEORGE RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:FORDS
Mailing Address - State:NJ
Mailing Address - Zip Code:08863-1981
Mailing Address - Country:US
Mailing Address - Phone:732-902-9154
Mailing Address - Fax:732-771-9020
Practice Address - Street 1:786 KING GEORGE RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:FORDS
Practice Address - State:NJ
Practice Address - Zip Code:08863-1981
Practice Address - Country:US
Practice Address - Phone:732-902-9154
Practice Address - Fax:732-771-9020
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2017-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00506600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional