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MRS. TARA MARIE NYSTROM MS, MHC
NPI 1235565722
Counselor - Mental Health in Coram, NY

Active since September 17, 2013
3600 ROUTE 112, CORAM, NY 11727(631) 920-8302(631) 920-8462 Get Directions Write a Review

NPPES record last updated: September 17, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mrs. Tara Marie Nystrom Ms, Mhc NPPES

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

MRS. TARA MARIE NYSTROM MS, MHC (NPI 1235565722) is an individual mental health provider in Coram, New York and active in the NPI registry since September 2013.

NPPES Registry Identity

NPI1235565722
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. TARA MARIE NYSTROMCredential: MS, MHC
Location Address3600 ROUTE 112Coram, NY 11727-4116
Mailing Address3 N 2nd StHolbrook, NY 11741-1102 · (631) 648-8312
Phone(631) 920-8302
Fax(631) 920-8462
Sole ProprietorNo
Enumeration DateSeptember 17, 2013
✔ NPI 1235565722 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
3600 ROUTE 112, Coram, NY 11727
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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.

RAQUEL FERNANDES
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
ANNE KIRKHAM
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
JENNIFER HATFIELD
Student in an Organized Health Care Education/Training Program
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (630) 920-8500
TRAVIS J WINGATE
Day Training/Habilitation Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8520
JENNIFER WILLA SIEGFRIED
Social Worker
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8500
SHANNON TIERNEY
Counselor (Mental Health)
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8610
ROSE PRISCILLA SANCHEZ
Peer Specialist
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8302
NATHALY ESTRADA
Student in an Organized Health Care Education/Training Program
3600 ROUTE 112
CORAM, NY 11727
Suffolk County (631) 920-8515

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tara Nystrom's NPI number?

The NPI number for Tara Nystrom is 1235565722. It was assigned to this individual provider in the NPPES registry on September 17, 2013.

Where is Tara Nystrom located?

Tara Nystrom practices at 3600 Route 112, Coram, NY 11727. The listed phone number is (631) 920-8302.

What is Tara Nystrom's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Tara Nystrom was last updated on September 17, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.