Provider Demographics
NPI:1467577569
Name:HAGAR, TAMARA S (MA, LLP, TLMFT, CAC)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:S
Last Name:HAGAR
Suffix:
Gender:F
Credentials:MA, LLP, TLMFT, CAC
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:SH
Other - Last Name:PAPANIKOLAOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LLP, TLMFT, CAC
Mailing Address - Street 1:10734 NADINE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48070-1520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1424 E 11 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2026
Practice Address - Country:US
Practice Address - Phone:248-548-4044
Practice Address - Fax:248-548-9239
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL973558103T00000X, 103TA0400X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TP2701X
MIL1041877106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Not Answered103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist