Provider Demographics
NPI:1265294425
Name:ZELTNER, TARA HOPPER (ESQ, LCSW)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:HOPPER
Last Name:ZELTNER
Suffix:
Gender:F
Credentials:ESQ, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MARION ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3620
Mailing Address - Country:US
Mailing Address - Phone:617-947-7897
Mailing Address - Fax:
Practice Address - Street 1:340 MAPLE ST STE 400
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3200
Practice Address - Country:US
Practice Address - Phone:508-485-9300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-24
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW2226561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical