Provider Demographics
NPI:1942752589
Name:FRENI, TARA MARIE (LLMFT, LLPC)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:MARIE
Last Name:FRENI
Suffix:
Gender:F
Credentials:LLMFT, LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4097 ASH TREE LN
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8063
Mailing Address - Country:US
Mailing Address - Phone:517-672-0529
Mailing Address - Fax:
Practice Address - Street 1:120 FLINT RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1112
Practice Address - Country:US
Practice Address - Phone:810-638-3603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015712101YP2500X
MI4101006706106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional