Provider Demographics
NPI:1881072825
Name:FOLARON, TAMARA (LCSW)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:FOLARON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1481 W 10TH ST
Mailing Address - Street 2:SMLESTR11
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-2803
Mailing Address - Country:US
Mailing Address - Phone:317-988-5284
Mailing Address - Fax:317-988-5620
Practice Address - Street 1:1481 W 10TH ST
Practice Address - Street 2:SMLESTR11
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-2803
Practice Address - Country:US
Practice Address - Phone:317-988-5284
Practice Address - Fax:317-988-5620
Is Sole Proprietor?:No
Enumeration Date:2015-05-11
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0192911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical