MEDICARE: TRIBE HEALTHCARE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	171400000X	Health & Wellness Coach
3	101Y00000X	Counselor
4	101YA0400X	Addiction (Substance Use Disorder) Counselor
5	171M00000X	Case Manager/Care Coordinator
6	225XM0800X	Mental Health Occupational Therapist
7	1041C0700X	Clinical Social Worker
8	175T00000X	Peer Specialist
9	101YP2500X	Professional Counselor
10	106H00000X	Marriage & Family Therapist
11	106S00000X	Behavior Technician
12	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1619720166
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRIBE HEALTHCARE

Provider Business Mailing Address
First Line	:	521 N ADAMS ST STE A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-3903
Country	:	US
Telephone Number	:	804-738-7423
Fax Number	:	804-738-8383

Provider Business Practice Location Address
First Line	:	521 N ADAMS ST STE A
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23220-3903
Country	:	US
Telephone Number	:	804-738-7423
Fax Number	:	804-738-8383

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. FATIMAH JORDAN
Credential	:	EXECUTIVE DIRECTOR
Telephone Number	:	804-738-7423

Provider Enumeration Date	:	04/05/2024
Last Update Date	:	02/06/2026

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Directions to “TRIBE HEALTHCARE ” Practice Location

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