Tara Pettit Deloach, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT001470 Issued in GA

Practice address

930 Stevens Creek Rd Ste 1
Augusta, GA 30907-3200

Phone

(706) 343-3661

NPI assigned

Apr 28, 2010

Last updated

Jan 1, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tara Pettit Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 22, 2025 through Sep 22, 2027

Specialty

Marriage and Family Therapist

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Tara Pettit Deloach LLC

  • Adult Mental Health Clinic/Center
  • Augusta, GA
  • NPI 1124897145
  Authorized official Same address or phone

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704067200000",
    "number": "1790002947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 STEVENS CREEK RD STE 1",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309073200",
            "telephone_number": "706-343-3661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 STEVENS CREEK RD STE 1",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309073200",
            "telephone_number": "706-343-3661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELOACH",
        "first_name": "TARA",
        "middle_name": "PETTIT",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-28",
        "last_updated": "2024-01-01",
        "certification_date": "2024-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "1313",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "PETTIT",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eladio Deleon Jr., DMD, MS
• Gabriela Marie Delgado, OTR/L
• William Delk
• Shannon Nisha Dellen, MD
• Kevin C Dellsperger, MD
• Alexis Jean Delousia
• James Demedici, RN
• Oksana Maria Demediuk, MD
• Meredith Koehler Dempsey
• Michael Dender, M.D.

• Marriage & Family Therapist in Augusta, GA
• Providers in Augusta, GA by specialty
• Marriage & Family Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.