Active NPI
Tara Robin
- Mental Health Counselor
- Glendale, AZ
National Provider Identifier
1073100707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LPC-19487
- Practice address
- 17100 N 67TH Ave Ste 400
Glendale, AZ 85308-3698 - Phone
- (602) 737-3681
- NPI assigned
- Dec 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-19487 | AZ | Primary |
Addresses
Primary practice location
17100 N 67TH Ave Ste 400
Glendale, AZ 85308-3698
Mailing address
15528 N 159TH LN
Surprise, AZ 85374-7829
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-19487 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1609200000000",
"number": "1073100707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15528 N 159TH LN",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853747829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17100 N 67TH AVE STE 400",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853083698",
"telephone_number": "602-737-3681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBIN",
"first_name": "TARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-29",
"last_updated": "2020-12-29",
"certification_date": "2020-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LPC-19487",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.