Provider Demographics
NPI:1013738848
Name:TARA HURLEY LMFT LLC
Entity type:Organization
Organization Name:TARA HURLEY LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:HURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MED LMFT
Authorized Official - Phone:617-863-2483
Mailing Address - Street 1:11 SAGAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-2107
Mailing Address - Country:US
Mailing Address - Phone:781-405-4882
Mailing Address - Fax:
Practice Address - Street 1:11 SAGAMORE AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-2107
Practice Address - Country:US
Practice Address - Phone:781-405-4882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health