Provider Demographics
NPI:1437863420
Name:VAN HEST, TARA MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:MICHELLE
Last Name:VAN HEST
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 1:15 VESSEL RD
Mailing Address - Street 2:
Mailing Address - City:WARETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08758-2239
Mailing Address - Country:US
Mailing Address - Phone:609-968-0205
Mailing Address - Fax:
Practice Address - Street 1:15 VESSEL RD
Practice Address - Street 2:
Practice Address - City:WARETOWN
Practice Address - State:NJ
Practice Address - Zip Code:08758-2239
Practice Address - Country:US
Practice Address - Phone:609-968-0205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00917200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health