MEDICARE: TAMMY DARLENE KIRBY LPC

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	0701003071	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	088865M	OTHER	VA	SENTARA
3	455602000	OTHER	VA	MAGELLAN
4	115902	OTHER	VA	ANTHEM
5	501508	OTHER	VA	VALUE OPTIONS
6	2116251	OTHER	VA	CIGNA
7	7275302	OTHER	VA	AETNA

General Provider Information

NPI Number	:	1982703906
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY DARLENE KIRBY LPC

Provider Business Mailing Address
First Line	:	7277 HANOVER GREEN DR
Second Line	:	SUITE A-2
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-1764
Country	:	US
Telephone Number	:	804-730-9660
Fax Number	:	804-569-7722

Provider Business Practice Location Address
First Line	:	7277 HANOVER GREEN DR
Second Line	:	SUITE A-2
City	:	MECHANICSVILLE
State	:	VA
Zip	:	23111-1764
Country	:	US
Telephone Number	:	804-730-9660
Fax Number	:	804-569-7722

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/12/2019

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