MEDICARE: TAMMIE TAYLOR LPC, NCC, CADC

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
1	101YM0800X	Mental Health Counselor	0701013845	VA
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1255079885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMIE TAYLOR LPC, NCC, CADC

Provider Business Mailing Address
First Line	:	900 GRANBY ST STE 205
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-2567
Country	:	US
Telephone Number	:	757-613-9220
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 GRANBY ST STE 205
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-2567
Country	:	US
Telephone Number	:	757-613-9220
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2022
Last Update Date	:	04/06/2026

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