MEDICARE: TAMMY MCCALLISTER LMHC

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	MH11636	FL

General Provider Information

NPI Number	:	1609185610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY MCCALLISTER LMHC

Provider Business Mailing Address
First Line	:	8400 RED BUG LAKE RD STE 2080
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6835
Country	:	US
Telephone Number	:	833-769-3524
Fax Number	:	321-348-9984

Provider Business Practice Location Address
First Line	:	8400 RED BUG LAKE RD STE 2080
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-6835
Country	:	US
Telephone Number	:	407-537-9450
Fax Number	:

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

Provider Enumeration Date	:	09/26/2010
Last Update Date	:	12/29/2025

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