| Tara Yardley Lpc Llc | |
|
1133 W Main St Suite 101 Blue Springs MO 64015-3694 | |
| (816) 679-1524 | |
| Not Available |
| Full Name | Tara Yardley Lpc Llc |
|---|---|
| Speciality | Counselor |
| Location | 1133 W Main St, Blue Springs, Missouri |
| Authorized Official Name and Position | Tara Beth Yardley (OWNER) |
| Authorized Official Contact | 8166791524 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Yardley Lpc Llc 10402 E Sheley Rd Independence MO 64052-2649 Ph: (816) 679-1524 | Tara Yardley Lpc Llc 1133 W Main St Suite 101 Blue Springs MO 64015-3694 Ph: (816) 679-1524 |
| NPI Number | 1437495017 |
|---|---|
| Provider Enumeration Date | 12/31/2012 |
| Last Update Date | 03/22/2013 |
| Medicare PECOS PAC ID | 0042657926 |
|---|---|
| Medicare Enrollment ID | O20240327002548 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437495017 | NPI | - | NPPES |
| 153990 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2010021552 (Missouri) | Primary |
| Provider Name | Tara B Yardley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326343179 PECOS PAC ID: 1951748839 Enrollment ID: I20240328000966 |
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