MEDICARE: AS I AM COUNSELING & THERAPY, LLC

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	251S00000X	Community/Behavioral Health Agency
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1285205443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AS I AM COUNSELING & THERAPY, LLC

Provider Business Mailing Address
First Line	:	1010 N 12TH AVE STE 324
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-3492
Country	:	US
Telephone Number	:	850-359-2925
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 N 12TH AVE STE 324
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32501-3492
Country	:	US
Telephone Number	:	850-359-2925
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TANYA LAFAYE MCINTYRE
Credential	:	LMHC
Telephone Number	:	850-359-2925

Provider Enumeration Date	:	07/08/2021
Last Update Date	:	07/08/2021

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