TARA SHAWNISE BRANNON
NPI 1619869559
Counselor - Mental Health in Waukegan, IL
Active since July 16, 2025
About Tara Shawnise Brannon NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TARA SHAWNISE BRANNON (NPI 1619869559) is an individual mental health provider in Waukegan, Illinois and active in the NPI registry since July 2025.
NPPES Registry Identity
NPI1619869559
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameTARA SHAWNISE BRANNON
Location Address2410 BELVIDERE RDWaukegan, IL 60085-6165
Mailing Address2410 Belvidere RdWaukegan, IL 60085-6165 · (847) 377-8686
Phone(847) 377-8686
Sole ProprietorNo
Enumeration DateJuly 16, 2025
NPPES CertifiedJuly 16, 2025
✔ NPI 1619869559 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
2410 BELVIDERE RD, Waukegan, IL 60085
Other Names 1
Former Name (1)Tara Shawnise James
Other Providers at the Same Location NPPES 15
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619869559, enumerated as an "individual" on July 16, 2025.
The provider is located at 2410 BELVIDERE RD WAUKEGAN, IL 60085 and the phone number is (847) 377-8686.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
