Tara Carlotta Fasol, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180014503 Issued in IL

Practice address

218 E Main St
West Frankfort, IL 62896-2406

Phone

(618) 242-6944

NPI assigned

Apr 25, 2023

Last updated

Apr 25, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in IL

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  IL, Professional

  Medicare reassignment NPD
• Fig & Vine

  • Mental Health Counselor
  • West Frankfort, IL
  • NPI 1902773690
  NPD
• Spero Family Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Frankfort, IL
  • NPI 1497071989
  NPD (past)

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1265120554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11599 S COUNTY LINE RD",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628964954",
            "telephone_number": "618-923-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962406",
            "telephone_number": "618-242-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASOL",
        "first_name": "TARA",
        "middle_name": "CARLOTTA",
        "name_prefix": "Dr.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180014503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Geri Ann Ellis, ATC
• Janalyn Elwood, NP
• Crystal Evans, AAS,RN
• Desrie Dawn Farley, M.A.E.D., ED.S.
• Randi Farmer
• Fig & Vine
• Holly Michelle Filkins, LPN
• Samantha Finn
• Karsen Finney
• Kendra Megan Fischer, FNP-C

• Professional Counselor in West Frankfort, IL
• Providers in West Frankfort, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.