Tara Lynn Dively, M.A., LMFT

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

MF000585 Issued in PA

Practice address

29 N Market St
Selinsgrove, PA 17870-1924

Phone

(717) 221-8004

Fax

(717) 221-8006

NPI assigned

Dec 8, 2015

Last updated

Dec 8, 2015By 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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 25, 2024 through Jun 25, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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.

• Connections Relational Therapy LLC

  • Marriage & Family Therapist
  • Selinsgrove, PA
  • NPI 1366109928
  NPD Authorized official

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

{
    "created_epoch": "1449532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1386019990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2019 N 2ND ST",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171022147",
            "telephone_number": "717-221-8004",
            "fax_number": "717-221-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 N MARKET ST",
            "city": "SELINSGROVE",
            "state": "PA",
            "postal_code": "178701924",
            "telephone_number": "717-221-8004",
            "fax_number": "717-221-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVELY",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-08",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "MF000585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Romaine Decker, LPC
• Dental Care Associates, West
• Krystin Devine, M.S., NCC, LPC
• DH&L Ambulance League
• Mark E Dincher, DMD
• Diversified Construction, Inc.
• Divine Providence Hospital of the Sisters of Christian Charity
• Anthony DO, O.D.
• Christine S. Dotterer, MD
• Dr. Henry G Yavorek MD

• Clinical Social Worker in Selinsgrove, PA
• Providers in Selinsgrove, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.