Tara L Ernst, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

19051 Issued in AZ

Practice address

23107 E Via del Sol
Queen Creek, AZ 85142-1275

Phone

(480) 600-6838

Fax

(833) 623-4430

NPI assigned

Jun 6, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1654473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1902535982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S MONTEZUMA ST STE 205206",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863034712",
            "telephone_number": "928-756-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23107 E VIA DEL SOL",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421275",
            "telephone_number": "480-600-6838",
            "fax_number": "833-623-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "TARA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-06",
        "last_updated": "2022-06-06",
        "certification_date": "2022-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "19051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI OF CLINICAL SUPERVISOR (MARIE TUELLER, MED, LPC)",
            "identifier": "1710412382",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; 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.