Healthcare Provider Details

I. General information

NPI: 1710203963
Provider Name (Legal Business Name): TARA TORMEY BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 WALL ST STE 205
MARTINSVILLE VA
24112-2700
US

IV. Provider business mailing address

6 WALL ST STE 205
MARTINSVILLE VA
24112-2700
US

V. Phone/Fax

Practice location:
  • Phone: 757-268-6720
  • Fax:
Mailing address:
  • Phone: 757-268-6720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701015824
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: