Provider Demographics
NPI:1073739942
Name:SPEARS, TARA LYNN (MA, LMFT, LMHC)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:LYNN
Last Name:SPEARS
Suffix:
Gender:
Credentials:MA, LMFT, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:397 WEKIVA SPRINGS RD STE 205
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-3697
Mailing Address - Country:US
Mailing Address - Phone:407-405-3257
Mailing Address - Fax:
Practice Address - Street 1:397 WEKIVA SPRINGS RD STE 205
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-3697
Practice Address - Country:US
Practice Address - Phone:407-405-3257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10886101YM0800X
FLMT2336106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001742000Medicaid