MEDICARE: MRS. TAMIKA N BAIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1427703974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMIKA N BAIN

Provider Business Mailing Address
First Line	:	4045 PAYNE RD
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-1227
Country	:	US
Telephone Number	:	336-362-6588
Fax Number	:

Provider Business Practice Location Address
First Line	:	4045 PAYNE RD
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-1227
Country	:	US
Telephone Number	:	336-362-6588
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2022
Last Update Date	:	02/14/2022

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Directions to “ MRS. TAMIKA N BAIN ” Practice Location

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