Provider Demographics
NPI:1578275145
Name:AHEARN SIMINGTON, TARA LYN (LPC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:LYN
Last Name:AHEARN SIMINGTON
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 1:103 NEW ST
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18640-2123
Mailing Address - Country:US
Mailing Address - Phone:570-954-0047
Mailing Address - Fax:
Practice Address - Street 1:103 NEW ST
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:PA
Practice Address - Zip Code:18640-2123
Practice Address - Country:US
Practice Address - Phone:570-954-0047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-15
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional