Active NPI 1104389071 Individual Practitioner Female Practitioner

Tara Lynn Ketteringham , LCPC

Counselor - Professional • Frederick, MD

Professional Overview & Biography Verified Profile Summary

Tara Ketteringham, LCPC is a registered healthcare professional specializing in Counselor - Professional in Frederick, MD. Practice services are available at 5412 OLD NATIONAL PIKE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

5412 Old National Pike

Frederick, MD 217023640

Telephone 2404900256

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Frederick, MD

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 15.6 Yrs

State Avg: 17.2 Yrs

Regional Practice Density

200 Specialists

Practicing in Frederick, MD (4138 Statewide)

Telehealth Adoption Rate

9.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2023-02-21

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License MD LC12334

Definition to come...

Counselor - Professional

NUCC Taxonomy Code: 101YP2500X

State License MD LGP9228

Definition to come...

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Practice Location February 21, 2023

Registered at 5412 OLD NATIONAL PIKE, FREDERICK, MD 217023640 (Tel: 2404900256)

📍

Updated Business Mailing Address February 21, 2023

Registered at 5412 OLD NATIONAL PIKE, FREDERICK, MD 217023640 (Tel: 2404900256)

👤

Provider Name / Credentials Updated February 21, 2023

Recorded as TARA KETTERINGHAM, LCPC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 21, 2023

Counselor (License #LC12334 in MD)

✅

NPI Profile Active April 09, 2019

NPI status registered as active in NPPES database

📍

Updated Practice Location April 09, 2019

Registered at 10 N JEFFERSON ST STE 403, FREDERICK, MD 217014823 (Tel: 2408889642)

📍

Updated Business Mailing Address April 09, 2019

Registered at 10 N JEFFERSON ST STE 403, FREDERICK, MD 217014823 (Tel: 2408889642)

👤

Provider Name / Credentials Updated April 09, 2019

Recorded as TARA KETTERINGHAM, LGPC

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2019

Counselor (License #LGP9228 in MD)

🟢

Initial NPI Registration & Enumeration April 09, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104389071

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 09, 2019

Last Update: February 21, 2023

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

5412 Old National Pike

Frederick, MD 217023640

Phone: 2404900256

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.