Individual provider Active NPI

Tara Huddleston, MS, LPC

  • Professional Counselor
  • Dallas, GA
National Provider Identifier
1346510930
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC006609 Issued in GA
Practice address
702 W Memorial Dr
Dallas, GA 30132-4122
Phone
(678) 332-7955
NPI assigned
Jan 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC006609 GA Primary

Addresses

Primary practice location

702 W Memorial Dr
Dallas, GA 30132-4122

Mailing address

702 W Memorial Dr
Dallas, GA 30132-4122
Phone (678) 332-7955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20240814002892 GA Practitioner - Mental Health Counselor 9638617269 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Northrop Connection, LLCGroup PAC ID 6800104506, 8 clinicians

Practice addresses (Care Compare)

702 W Memorial Dr
Dallas, GA 30132-4122
Phone (678) 332-7955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
LPC006609GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Northrop Connection, LLC CurrentSince Aug 1, 2024 Accepting new patients
Highland Rivers CSB Past Accepting new patients
Highland Rivers Community Service Board Past Accepting new patients

Locations

702 W Memorial Dr
Dallas, GA 30132
Phone (678) 332-7955

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1346510930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 W MEMORIAL DR",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324122",
            "telephone_number": "678-332-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 W MEMORIAL DR",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301324122",
            "telephone_number": "678-332-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTON",
        "first_name": "TARA",
        "credential": "MS, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.