TARA D. ANCRUM LPC NPI 1275086480

NPI Information

NPI: 1275086480
Provider Name: TARA D. ANCRUM, LPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

PECOS Registration: Yes

Address:
5740 ANCRUM BUTLER LN
HOLLYWOOD, SC
ZIP 29449
Phone: (843) 437-0372
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Tara D. Ancrum, LPC is a professional counselor in Hollywood, SC. Tara D. Ancrum, LPC NPI is 1275086480. 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:

5740 ANCRUM BUTLER LN
HOLLYWOOD, SC
ZIP 29449-101
Phone: (843) 437-0372

The NPI 1275086480 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 7/25/2016 and was last updated on 4/21/2022.

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	101YM0800X	Counselor	Mental Health	6589	SOUTH CAROLINA	No
2	101YM0800X	Counselor	Mental Health	6126	SOUTH CAROLINA	No
3	101YP2500X	Counselor	Professional	6589	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	435201	MEDICAID	SOUTH CAROLINA

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: 5/5/2024

NPI Synchronization or Removal

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