Provider Demographics
NPI:1053597401
Name:GRALL, TARA COCHRAN (LPC, RPT)
Entity type:Individual
Prefix:MRS
First Name:TARA
Middle Name:COCHRAN
Last Name:GRALL
Suffix:
Gender:F
Credentials:LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 W HIGGINS RD
Mailing Address - Street 2:105
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-7220
Mailing Address - Country:US
Mailing Address - Phone:888-870-1775
Mailing Address - Fax:
Practice Address - Street 1:2500 W HIGGINS RD
Practice Address - Street 2:105
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-7220
Practice Address - Country:US
Practice Address - Phone:888-870-1775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MS1586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health