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NPI Code Detail

MEDICARE: MS. TAMMY A NOLLER MS LPC

MEDICARE: MS. TAMMY A NOLLER MS LPC
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 Counselor002473MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
129310015OTHERMOBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447337472
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TAMMY A NOLLER MS LPC
Provider Business Mailing Address
First Line : 2885 W BATTLEFIELD ST
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65807-3952
Country : US
Telephone Number : 417-761-5000
Fax Number : 417-761-5065
Provider Business Practice Location Address
First Line : 17844 E 23RD ST S
Second Line :
City : INDEPENDENCE
State : MO
Zip : 64057-1840
Country : US
Telephone Number : 816-254-3652
Fax Number : 816-254-9243
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 06/20/2022

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