MEDICARE: MRS. TAMEIKA LASHOUN IVEY LPC, NCC

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	068.0135528	VT
2	101YP2500X	Professional Counselor	TPMC3218	FL
3	101YP2500X	Professional Counselor	PC-0011497	DE
4	101YP2500X	Professional Counselor	2971386	ID
5	101YP2500X	Professional Counselor	006694	CT
6	101YP2500X	Professional Counselor	LPC009608	GA
7	101YP2500X	Professional Counselor	TLC548PC	SC

General Provider Information

NPI Number	:	1902170293
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMEIKA LASHOUN IVEY LPC, NCC

Provider Business Mailing Address
First Line	:	114 OAKWOOD DR
Second Line	:
City	:	HARLEM
State	:	GA
Zip	:	30814-4908
Country	:	US
Telephone Number	:	706-986-9357
Fax Number	:

Provider Business Practice Location Address
First Line	:	114 OAKWOOD DR
Second Line	:
City	:	HARLEM
State	:	GA
Zip	:	30814-4908
Country	:	US
Telephone Number	:	706-986-9357
Fax Number	:

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

Provider Enumeration Date	:	03/04/2012
Last Update Date	:	12/10/2025

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