Active NPI
Tara Frederick
- Mental Health Counselor
- Cherry Hill, NJ
National Provider Identifier
1265239198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 57 Haddonfield Rd
Cherry Hill, NJ 08002-4813 - Phone
- (609) 889-8100
- NPI assigned
- Feb 27, 2025
- Sex
- Female
- Sole proprietor
- No
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 | Primary |
Addresses
Primary practice location
57 Haddonfield Rd
Cherry Hill, NJ 08002-4813
Mailing address
1504 Ocean Rd
Wall, NJ 07719-9005
Phone (732) 221-6270
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740614400000",
"number": "1265239198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1504 OCEAN RD",
"city": "WALL",
"state": "NJ",
"postal_code": "077199005",
"telephone_number": "732-221-6270"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 HADDONFIELD RD",
"city": "CHERRY HILL",
"state": "NJ",
"postal_code": "080024813",
"telephone_number": "609-889-8100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "TARA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-27",
"last_updated": "2025-02-27",
"certification_date": "2025-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cherry Hill, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.