Provider Demographics
NPI:1861516155
Name:GALEANO, TARA (LPC)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:
Last Name:GALEANO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:GALEANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:954 NORTH ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-3419
Mailing Address - Country:US
Mailing Address - Phone:303-544-1400
Mailing Address - Fax:
Practice Address - Street 1:954 NORTH ST
Practice Address - Street 2:SUITE 306
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-3419
Practice Address - Country:US
Practice Address - Phone:303-544-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3677101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health