Tara Logan, MA, LLPC, LLMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

4151000532 Issued in MI

Practice address

157 S Kalamazoo Mall Ste 250
Kalamazoo, MI 49007-4828

Phone

(269) 422-0565

NPI assigned

Jul 15, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1225646300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 N PARK ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490071806",
            "telephone_number": "269-422-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 S KALAMAZOO MALL STE 250",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490074828",
            "telephone_number": "269-422-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "TARA",
        "credential": "MA, LLPC, LLMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401018406",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MI",
            "license": "4151000532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Jean Lockwood, PA
• Mark E Loehrke, M.D.
• Logan Community Resources
• Logan Community Resources Inc
• Monyea Logan
• James Gregory Lohman, O.T.
• Keith Lohman
• Essa Loinab
• James L Loker, MD
• Ashlynn Loll

• Marriage & Family Therapist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Marriage & Family Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.