Healthcare Provider Details

I. General information

NPI: 1700024452
Provider Name (Legal Business Name): TAMMY LEE EDMONDS MA LPC NCC CCTP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMMY LEE MCPHERSON MA LPC NCC CCTP

II. Dates (important events)

Enumeration Date: 02/02/2009
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 W HURON AVE STE C
BAD AXE MI
48413-1177
US

IV. Provider business mailing address

P.O. BOX 142
BAD AXE MI
48413
US

V. Phone/Fax

Practice location:
  • Phone: 989-269-5180
  • Fax: 989-623-0398
Mailing address:
  • Phone: 989-269-5180
  • Fax: 989-623-0398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberL 1121008
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401006872
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: