Tara Lee Lawrence, LPC

Individual provider Active NPI Mental Health Counselor · Winchester, ID

NPI 1023708161 · NPPES record last updated May 11, 2023

Key facts

NPI
1023708161
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
COUI-8239 (ID)
Practice address
1995 Winchester Road
Winchester, ID 83555-8355
Phone
(509) 520-9869
NPI assigned
May 11, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
COUI-8239IDMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X COUI-8239 ID Yes

Addresses

Primary practice location

1995 Winchester Road
Winchester, ID 83555-8355

Mailing address

PO Box 89
Winchester, ID 83555-0089
Phone (509) 520-9869

Other practice location 1

156 Cutterbee Pl
Touchet, WA 99360-5003
Phone (509) 520-9869

Other providers in Winchester, ID

All providers in Winchester, ID · Mental Health Counselor in Idaho

Sources for this page

Verify at the official NPI Registry.