Provider Demographics
NPI:1073407847
Name:COEN, TARA (LPC)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:COEN
Suffix:
Gender:X
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 PINE ST
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-3513
Mailing Address - Country:US
Mailing Address - Phone:719-766-0110
Mailing Address - Fax:
Practice Address - Street 1:2951 E US HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-2701
Practice Address - Country:US
Practice Address - Phone:719-204-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0015251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health