MEDICARE: TAMARA ANDERSON

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	LPC-2934	WY

General Provider Information

NPI Number	:	1962124479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA ANDERSON

Provider Business Mailing Address
First Line	:	1495 ROAD 137
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82009-9459
Country	:	US
Telephone Number	:	307-631-7570
Fax Number	:

Provider Business Practice Location Address
First Line	:	1495 ROAD 137
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82009-9459
Country	:	US
Telephone Number	:	307-631-7570
Fax Number	:

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

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	12/10/2025

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Directions to “ TAMARA ANDERSON ” Practice Location

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