Individual provider · Type 1 NPI

Tara Marie Nystrom, MS, MHC

Mental Health Counselor · Coram, NY

NPI number 1235565722 Active

Practice location

3600 Route 112
Coram, NY 11727-4116

Fax (631) 920-8462

Mailing address

3 N 2nd St
Holbrook, NY 11741-1102

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1235565722

Tara Marie Nystrom, MS, MHC's National Provider Identifier is 1235565722, issued on Sep 17, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Coram, NY. The record was last updated on Sep 17, 2013.