Tara Mallard George, LPC, RN

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701003429 Issued in VA

Practice address

4914 Fitzhugh Ave Ste 214
Richmond, VA 23230-3534

Phone

(804) 377-3955

Fax

(804) 377-3956

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Foundations for Life Counseling Services, LLC

  • Mental Health Counselor
  • Richmond, VA
  • NPI 1902025844
  Medicare reassignment NPD Authorized official
• Yana Health Care Services, LLC

  • Clinical Medical Laboratory
  • Richmond, VA
  • NPI 1659093045
  NPD

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1215021712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4914 FITZHUGH AVE STE 214",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303534",
            "telephone_number": "804-467-2606",
            "fax_number": "804-377-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4914 FITZHUGH AVE STE 214",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232303534",
            "telephone_number": "804-377-3955",
            "fax_number": "804-377-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "TARA",
        "middle_name": "MALLARD",
        "name_prefix": "Mrs.",
        "credential": "LPC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701003429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "VA005415781",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda George, MD
• Ansa George, MSN, PMHNP-BC
• Kimberly C George, MD
• Ligee Susan George, MD
• Sajid Melvin George, M.D
• Thomas Nedumkallel George, M.D.
• Tracie Fritzlen George, CRNA
• Anastasia Georges, ED.S., M.S.
• George Georges, MD
• Hlynur Georgsson, MD

• Professional Counselor in Richmond, VA
• Providers in Richmond, VA by specialty
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.