Provider Demographics
NPI:1952451197
Name:SCHOELLER, TARA L (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:L
Last Name:SCHOELLER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11675 CENTURY DR UNIT C
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-8367
Mailing Address - Country:US
Mailing Address - Phone:651-247-5126
Mailing Address - Fax:651-770-1879
Practice Address - Street 1:11675 CENTURY DR UNIT C
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-8367
Practice Address - Country:US
Practice Address - Phone:651-247-5126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLICSW153141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical