Provider Demographics
NPI:1275955130
Name:CHELF, TAMMY PIERVINCENTI (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:PIERVINCENTI
Last Name:CHELF
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5706 N GREENWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79764-9600
Mailing Address - Country:US
Mailing Address - Phone:432-557-1980
Mailing Address - Fax:
Practice Address - Street 1:1012 W MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79763-3341
Practice Address - Country:US
Practice Address - Phone:432-335-9659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11295101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)