Provider Demographics
NPI:1215237003
Name:TARR, LAURA (CNS-PMH)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:TARR
Suffix:
Gender:F
Credentials:CNS-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20545 CENTER RIDGE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3423
Mailing Address - Country:US
Mailing Address - Phone:440-568-6108
Mailing Address - Fax:
Practice Address - Street 1:20545 CENTER RIDGE RD STE 305
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3423
Practice Address - Country:US
Practice Address - Phone:216-789-3929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN222955163WP0807X, 364SP0807X
OHRN328413364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent