MEDICARE: TAMMY KAY STUTLER 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
1	101YM0800X	Mental Health Counselor	3059	WV
2	101YP2500X	Professional Counselor	6487	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922354331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMMY KAY STUTLER MS, LPC

Provider Business Mailing Address
First Line	:	801 47TH AVE N
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29577-5402
Country	:	US
Telephone Number	:	843-997-1538
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 PROFESSIONAL PL STE 101
Second Line	:
City	:	BRIDGEPORT
State	:	WV
Zip	:	26330-4599
Country	:	US
Telephone Number	:	304-513-3495
Fax Number	:

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

Provider Enumeration Date	:	08/03/2012
Last Update Date	:	04/15/2026

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