Individual provider Active NPI

Tara L Moyle

  • Mental Health Counselor
  • Glen Ridge, NJ
National Provider Identifier
1376328468
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37AC00540100 Issued in NJ
Practice address
225 Ridgewood Ave Unit 6
Glen Ridge, NJ 07028-6601
Phone
(347) 880-2161
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37AC00540100 NJ Primary

Addresses

Primary practice location

225 Ridgewood Ave Unit 6
Glen Ridge, NJ 07028-6601

Mailing address

30 Yantecaw Ave
Bloomfield, NJ 07003-2835
Phone (347) 880-2161

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

State licenses

LicenseStateTypeSpecialty
37AC00540100NJMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1376328468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 YANTECAW AVE",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032835",
            "telephone_number": "347-880-2161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 RIDGEWOOD AVE UNIT 6",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070286601",
            "telephone_number": "347-880-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLE",
        "first_name": "TARA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00540100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Ridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.