Provider Demographics
NPI:1023416807
Name:RICHTER, TARA LYNN (PSYD, LP)
Entity type:Individual
Prefix:DR
First Name:TARA
Middle Name:LYNN
Last Name:RICHTER
Suffix:
Gender:F
Credentials:PSYD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 TIMBERLINE LN
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55811-4454
Mailing Address - Country:US
Mailing Address - Phone:218-341-5486
Mailing Address - Fax:218-481-7910
Practice Address - Street 1:205 W 2ND ST STE 120
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-1920
Practice Address - Country:US
Practice Address - Phone:218-481-7909
Practice Address - Fax:218-481-7910
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3820-57103TC0700X
MNLP6046103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical