Healthcare Provider Details

I. General information

NPI: 1710509351
Provider Name (Legal Business Name): TAMICA EDMONDS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAMICA DAVIS LPC

II. Dates (important events)

Enumeration Date: 05/16/2020
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10045 MIDLOTHIAN TPKE FL 2
NORTH CHESTERFIELD VA
23235-4857
US

IV. Provider business mailing address

10045 MIDLOTHIAN TPKE FL 2
NORTH CHESTERFIELD VA
23235-4857
US

V. Phone/Fax

Practice location:
  • Phone: 804-304-2580
  • Fax: 804-773-4554
Mailing address:
  • Phone: 804-304-2580
  • Fax: 804-773-4554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701011493
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: