TARA FREY RSA
NPI 1154908085
Counselor - Addiction (Substance Use Disorder) in Waterloo, IL

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

Active since March 26, 2021

988 N ILLINOIS ROUTE 3, WATERLOO, IL 62298(618) 939-4444 Get Directions Write a Review

NPPES record last updated: December 30, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 30, 2025, Mar 26, 2021 (2 updates tracked since 2021).

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About Tara Frey Rsa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA FREY RSA (NPI 1154908085) is an individual addiction (substance use disorder) provider in Waterloo, Illinois, licensed in Illinois (37711) and active in the NPI registry since March 2021.

NPPES Registry Identity

NPI1154908085

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameTARA FREYCredential: RSA

Location Address988 N ILLINOIS ROUTE 3Waterloo, IL 62298-1059

Mailing Address988 N Illinois Route 3Waterloo, IL 62298-1059 · (618) 939-4444

Phone(618) 939-4444

Sole ProprietorYes

Enumeration DateMarch 26, 2021

Last NPPES UpdateDecember 30, 20252 updates tracked since enumeration

NPPES CertifiedDecember 30, 2025

✔ NPI 1154908085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in IL · 37711

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

988 N ILLINOIS ROUTE 3, Waterloo, IL 62298

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER NICOLE SHEMONIC BA, LPC

Counselor (Professional)