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NPI Code Detail

MEDICARE: JAY BURR TOMPKINS M.A

MEDICARE:   JAY BURR TOMPKINS  M.A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor6401223138MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16401223138OTHERMIPROFESSIONAL COUNSELOR

General Provider Information

NPI Number : 1023614138
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAY BURR TOMPKINS M.A
Provider Business Mailing Address
First Line : 4017 W MAIN ST STE 100
Second Line :
City : KALAMAZOO
State : MI
Zip : 49006-3731
Country : US
Telephone Number : 269-849-9572
Fax Number :
Provider Business Practice Location Address
First Line : 4017 W MAIN ST STE 100
Second Line :
City : KALAMAZOO
State : MI
Zip : 49006-3731
Country : US
Telephone Number : 269-205-6339
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2020
Last Update Date : 04/04/2023

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Directions to “ JAY BURR TOMPKINS M.A” Practice Location

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