Healthcare Provider Details

I. General information

NPI: 1073438669
Provider Name (Legal Business Name): TATUM HARDISON COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E MAIN STREET
FREMONT NC
27830
US

IV. Provider business mailing address

PO BOX 662
FREMONT NC
27830-0662
US

V. Phone/Fax

Practice location:
  • Phone: 252-904-1842
  • Fax:
Mailing address:
  • Phone: 252-904-1842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA TATUM HARDISON
Title or Position: OWNER/OPERATOR/PSYCHOTHERAPIST
Credential: LCSW, LCAS, CCS
Phone: 252-904-1842