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General NPI Number Information
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NPI Number | 1598527327
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Entity Type | Individual
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Provider Name | TAMARA CHEYENNE PACHECO LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 8025 TEA OLIVE TER
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City | PALMETTO
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State | FL
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Zip | 34221-6657
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Country | US
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Telephone | 727-354-8020
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Fax | 727-354-8097
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Provider Business Mailing Address
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Address Line | 8025 TEA OLIVE TER
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City | PALMETTO
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State | FL
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Zip | 34221-6657
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Country | US
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Telephone | 850-716-2420
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6355G
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW03164
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW23490
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License Number State | FL
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