Provider Demographics
NPI:1528506318
Name:ALVES-WARNER, TARA (LAMFT)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:ALVES-WARNER
Suffix:
Gender:F
Credentials:LAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-3425
Mailing Address - Country:US
Mailing Address - Phone:612-289-4755
Mailing Address - Fax:
Practice Address - Street 1:333 WASHINGTON AVE N STE 500
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55401-2263
Practice Address - Country:US
Practice Address - Phone:612-289-4755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2972106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist