Provider Demographics
NPI:1427090380
Name:PARKHURST, TARA MICHELLE (LCSW)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:MICHELLE
Last Name:PARKHURST
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:MICHELLE
Other - Last Name:BROWN PARKHURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:20250 SADIE LN
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-1515
Mailing Address - Country:US
Mailing Address - Phone:573-268-4419
Mailing Address - Fax:
Practice Address - Street 1:121 E BROADWAY BLVD STE 107
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-5800
Practice Address - Country:US
Practice Address - Phone:573-268-4419
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20040337381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical