TARA LYNN KETTERINGHAM LCPC NPI 1104389071

NPI Information

NPI: 1104389071
Provider Name: TARA LYNN KETTERINGHAM, LCPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
5412 OLD NATIONAL PIKE
FREDERICK, MD
ZIP 21702
Phone: (240) 490-0256
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Tara Lynn Ketteringham, LCPC is a professional counselor in Frederick, MD. Tara Lynn Ketteringham, LCPC NPI is 1104389071. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5412 OLD NATIONAL PIKE
FREDERICK, MD
ZIP 21702-640
Phone: (240) 490-0256

The enumeration date for this NPI number is 4/9/2019 and was last updated on 2/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	LC12334	MARYLAND	Yes
2	101YP2500X	Counselor	Professional	LGP9228	MARYLAND	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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