Provider Demographics
NPI:1194714394
Name:MECKLEY-HILL, TARA MARIE (LPCC)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:MARIE
Last Name:MECKLEY-HILL
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 LOUISIANA AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1470
Mailing Address - Country:US
Mailing Address - Phone:419-356-6966
Mailing Address - Fax:419-873-0892
Practice Address - Street 1:330 LOUISIANA AVE
Practice Address - Street 2:SUITE C
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1470
Practice Address - Country:US
Practice Address - Phone:419-356-6966
Practice Address - Fax:419-873-0892
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0003735101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional