Tara Blair

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

1800 Craig Klawock Hwy # 241
Craig, AK 99921-0678

Phone

(907) 826-3891

NPI assigned

Nov 19, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Community Connections, Inc.

  • Community/Behavioral Health Agency
  • Ketchikan, AK
  • NPI 1396516068
  NPD (past)

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1568065720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 STEDMAN ST",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999016632",
            "telephone_number": "907-225-7825",
            "fax_number": "907-225-1541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 CRAIG KLAWOCK HWY # 241",
            "city": "CRAIG",
            "state": "AK",
            "postal_code": "999210678",
            "telephone_number": "907-826-3891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Lot 3C Block 5 Goose Creek",
            "address_purpose": "LOCATION",
            "city": "Thorne Bay",
            "state": "AK",
            "postal_code": "99919",
            "country_code": "US",
            "telephone_number": "907-617-7596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Robert Alley, PT
• Judith Aspery
• Patrick E Ballard, DO
• Jazmyn Bird
• Deborah Blair
• Patty Sue Boggs, CARE COORDINATOR
• Brenda Marie Bowie, NP
• Ryan Bowser
• Bettina Brentano
• Jessie Brookins

• All providers in Craig, AK
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.