Provider Demographics
NPI:1164952115
Name:TATUM, BARBARA PECIREP (LPC)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:PECIREP
Last Name:TATUM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 EAST WASHINGTON AVENUE, 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716
Mailing Address - Country:US
Mailing Address - Phone:732-794-7833
Mailing Address - Fax:
Practice Address - Street 1:52 RECKLESS PL
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1704
Practice Address - Country:US
Practice Address - Phone:732-794-7833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-13
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00586700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty