Provider Demographics
NPI:1407119548
Name:HABERMAN, TAMARA WHITEMAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:WHITEMAN
Last Name:HABERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 BOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-5501
Mailing Address - Country:US
Mailing Address - Phone:407-924-2389
Mailing Address - Fax:
Practice Address - Street 1:321 BOXWOOD DR
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:FL
Practice Address - Zip Code:33837-5501
Practice Address - Country:US
Practice Address - Phone:407-924-2389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical