MEDICARE: MS. LEA ALMOND TATE MSW, ACSW, LCSW

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	101YP2500X	Professional Counselor	000119	NC

General Provider Information

NPI Number	:	1558383026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEA ALMOND TATE MSW, ACSW, LCSW

Provider Business Mailing Address
First Line	:	136 LAUREL HAVEN ROAD
Second Line	:
City	:	FAIRVIEW
State	:	NC
Zip	:	28730
Country	:	US
Telephone Number	:	828-606-8478
Fax Number	:

Provider Business Practice Location Address
First Line	:	136 LAUREL HAVEN ROAD
Second Line	:
City	:	FAIRVIEW
State	:	NC
Zip	:	28730
Country	:	US
Telephone Number	:	828-606-8478
Fax Number	:

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/08/2007

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