Provider Demographics
NPI:1376833368
Name:ULMER, TAMARA MICHELLE (LPC-MH QMHP)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:MICHELLE
Last Name:ULMER
Suffix:
Gender:F
Credentials:LPC-MH QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 ELK ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7351
Mailing Address - Country:US
Mailing Address - Phone:605-343-7262
Mailing Address - Fax:605-343-7293
Practice Address - Street 1:2902 W MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-8174
Practice Address - Country:US
Practice Address - Phone:605-721-8822
Practice Address - Fax:605-721-8822
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD2232101YP2500X
SD34131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional