Provider Demographics
NPI:1124591748
Name:STEYER, TAMATHA MICHELLE (MA, PLPC, MAADC II)
Entity Type:Individual
Prefix:
First Name:TAMATHA
Middle Name:MICHELLE
Last Name:STEYER
Suffix:
Gender:F
Credentials:MA, PLPC, MAADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22100 BEAUMONT RD
Mailing Address - Street 2:
Mailing Address - City:CROCKER
Mailing Address - State:MO
Mailing Address - Zip Code:65452-7173
Mailing Address - Country:US
Mailing Address - Phone:573-842-7081
Mailing Address - Fax:
Practice Address - Street 1:704 ROUTE 66 W STE 101
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:MO
Practice Address - Zip Code:65583-8322
Practice Address - Country:US
Practice Address - Phone:573-433-4846
Practice Address - Fax:573-774-3317
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
MO2022050155101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician