Provider Demographics
NPI:1528404290
Name:MILLER, TARA M (MA)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:TARA
Other - Middle Name:M
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC, NCC
Mailing Address - Street 1:245 W RACE ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-1922
Mailing Address - Country:US
Mailing Address - Phone:814-443-4891
Mailing Address - Fax:
Practice Address - Street 1:793 OLD ROUTE 119 HWY N
Practice Address - Street 2:
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15701-1372
Practice Address - Country:US
Practice Address - Phone:724-465-5576
Practice Address - Fax:724-465-6379
Is Sole Proprietor?:No
Enumeration Date:2013-05-21
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional