Tara Acevedo, Psy.D., PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05587 Issued in MD

Legal business name

TARA ACEVEDO, PSY.D., PC

Practice address

6213 Deep Earth LN
Columbia, MD 21045-2565

Phone

(610) 217-0821

NPI assigned

Apr 27, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tara Acevedo, PSY.D.

Title

Executive Director

Phone

(610) 217-0821

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1073968061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6213 DEEP EARTH LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452565",
            "telephone_number": "610-217-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6213 DEEP EARTH LN",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452565",
            "telephone_number": "610-217-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARA ACEVEDO, PSY.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "610-217-0821",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Wayne Tang, PHARMD
• Star Tangyie-Che Niba, NP
• Tashera Tanner
• Kristina Tao, M.D.
• Tahel Tapiro
• Paul Tarectecan
• Iola Renee Tariq
• Margrette Peckeal Nkeng Tasily
• Joshua Tassler
• Barbara Martin Tatum, D.D.S.

• Clinical Psychologist in Columbia, MD
• Providers in Columbia, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.