Provider Demographics
NPI:1477233260
Name:CHAY, TIA LAVARION (DNP, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:LAVARION
Last Name:CHAY
Suffix:
Gender:F
Credentials:DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6107 BRITTANY CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-4247
Mailing Address - Country:US
Mailing Address - Phone:786-423-3736
Mailing Address - Fax:
Practice Address - Street 1:6107 BRITTANY CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-4247
Practice Address - Country:US
Practice Address - Phone:786-423-3736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN279305363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health