Provider Demographics
NPI:1558961318
Name:MARING, TARA CHRISTMAN (LPC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:CHRISTMAN
Last Name:MARING
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 1:631 PARKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-2229
Mailing Address - Country:US
Mailing Address - Phone:630-664-2939
Mailing Address - Fax:
Practice Address - Street 1:515 BUSSE HWY
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-3154
Practice Address - Country:US
Practice Address - Phone:847-685-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2382781101YS0200X
IL178.007694101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool