Healthcare Provider Details

I. General information

NPI: 1508623984
Provider Name (Legal Business Name): TANYA KISER RAGAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2024
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 S 6TH ST
GADSDEN AL
35901-4161
US

IV. Provider business mailing address

298 GNATVILLE RD
PIEDMONT AL
36272-5904
US

V. Phone/Fax

Practice location:
  • Phone: 256-310-9251
  • Fax:
Mailing address:
  • Phone: 256-310-9251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC05722
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: