Provider Demographics
NPI:1467772905
Name:WHITTEN, TAMARA (MS, LMFT, CFLE)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:WHITTEN
Suffix:
Gender:F
Credentials:MS, LMFT, CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3483 EVANS ST STE B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4529
Mailing Address - Country:US
Mailing Address - Phone:252-320-9359
Mailing Address - Fax:
Practice Address - Street 1:3483 EVANS ST
Practice Address - Street 2:STE. B
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4529
Practice Address - Country:US
Practice Address - Phone:252-531-3703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-07
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist