Provider Demographics
NPI:1518630946
Name:SHEFFIELD, TARA CAMILLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:CAMILLE
Last Name:SHEFFIELD
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 1:1240 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:LANTANA
Mailing Address - State:TX
Mailing Address - Zip Code:76226-5547
Mailing Address - Country:US
Mailing Address - Phone:817-368-7682
Mailing Address - Fax:
Practice Address - Street 1:1240 GRANT AVE
Practice Address - Street 2:
Practice Address - City:LANTANA
Practice Address - State:TX
Practice Address - Zip Code:76226-5547
Practice Address - Country:US
Practice Address - Phone:817-368-7682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82419101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional