Provider Demographics
NPI:1417420225
Name:METCALF, TARA (LMFT)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:METCALF
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:METCALF-GONZALES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1800 HWY 116 N
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95472-2607
Mailing Address - Country:US
Mailing Address - Phone:650-440-6493
Mailing Address - Fax:
Practice Address - Street 1:1800 HWY 116 N
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-2607
Practice Address - Country:US
Practice Address - Phone:650-440-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist