| Organization Name: | TARVID COUNSELING LLC |
| NPI Number: | 1386048551 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SALLY S TARVID (REGISTERED AGENT/MBR) |
| Mailing Address: | 740 Pilgrim Pkwy Suite 103 Elm Grove |
| State: | WI US |
| Postal Code: | 531222066 |
| Phone Number: | 4144910377 |
| Fax Number: | |
| NPI Enumeration Date: | 10/17/2014 |
| NPI Last Update Date: | 10/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 7099-123 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |