Provider Demographics
NPI:1700988490
Name:GEER-LEIKER, TARA ESTHER (LPC)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:ESTHER
Last Name:GEER-LEIKER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2513 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3556
Mailing Address - Country:US
Mailing Address - Phone:415-642-5968
Mailing Address - Fax:510-568-8416
Practice Address - Street 1:2513 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3556
Practice Address - Country:US
Practice Address - Phone:415-642-5968
Practice Address - Fax:510-568-8416
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004020209101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional