Provider Demographics
NPI:1407559800
Name:BRICE, TAMIKA D (NCC)
Entity Type:Individual
Prefix:
First Name:TAMIKA
Middle Name:D
Last Name:BRICE
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 HAMPSHIRE GLEN PKWY
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-4809
Mailing Address - Country:US
Mailing Address - Phone:757-342-4424
Mailing Address - Fax:
Practice Address - Street 1:43 HAMPSHIRE GLEN PKWY
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-4809
Practice Address - Country:US
Practice Address - Phone:757-342-4424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
VA101YM0800X
VA0704015180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)