Provider Demographics
NPI:1417181728
Name:PLEASANTS, TAMIA ANDREA (LCPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:TAMIA
Middle Name:ANDREA
Last Name:PLEASANTS
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:MS
Other - First Name:TAMIA
Other - Middle Name:ANDREA
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:15020 NEWCOMB LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1027
Mailing Address - Country:US
Mailing Address - Phone:301-684-4606
Mailing Address - Fax:240-331-0545
Practice Address - Street 1:4329 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2601
Practice Address - Country:US
Practice Address - Phone:301-684-4606
Practice Address - Fax:240-331-0545
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-14
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701009555101YP2500X
101YP2500X
DCPRC13959101YP2500X
MDLC6312101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1039814 00Medicaid