Provider Demographics
NPI:1891308086
Name:HAYS, TARA A (LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:TARA
Middle Name:A
Last Name:HAYS
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 508
Mailing Address - Street 2:
Mailing Address - City:LOLO
Mailing Address - State:MT
Mailing Address - Zip Code:59847-0508
Mailing Address - Country:US
Mailing Address - Phone:406-219-1112
Mailing Address - Fax:406-797-5008
Practice Address - Street 1:700 SW HIGGINS AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1495
Practice Address - Country:US
Practice Address - Phone:406-396-4130
Practice Address - Fax:406-797-5008
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT44112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health