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General NPI Number Information
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NPI Number | 1285389619
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Entity Type | Individual
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Provider Name | STEPHANIE TATUM LPCC
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Gender | Female
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Dates
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Enumeration Date | 02/15/2022
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Last Update Date | 10/26/2024
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Provider Practice Location Address
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Address Line | 2101 S BLACKHAWK ST STE 240
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City | AURORA
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State | CO
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Zip | 80014-1475
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Country | US
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Telephone | 720-386-2858
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Fax |
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Provider Business Mailing Address
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Address Line | 16890 E ALAMEDA PKWY. UNIT 472523
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City | AURORA
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State | CO
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Zip | 80047-2523
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Country | US
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Telephone | 720-386-2858
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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