Healthcare Provider Details

I. General information

NPI: 1134031115
Provider Name (Legal Business Name): TAMMIE MALARICH LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

573 FOREST HILL DR
YOUNGSTOWN OH
44515-3326
US

IV. Provider business mailing address

573 FOREST HILL DR
YOUNGSTOWN OH
44515-3326
US

V. Phone/Fax

Practice location:
  • Phone: 330-550-6778
  • Fax:
Mailing address:
  • Phone: 330-550-6778
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA23508
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: