Provider Demographics
NPI:1871484147
Name:MORAN, TARA (LCSW LCADC)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:MORAN
Suffix:
Gender:X
Credentials:LCSW LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SEARS AVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-2458
Mailing Address - Country:US
Mailing Address - Phone:732-788-8875
Mailing Address - Fax:
Practice Address - Street 1:117 SEARS AVE
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-2458
Practice Address - Country:US
Practice Address - Phone:732-788-8875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00381200101YA0400X
NJ44SC060601001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)