Provider Demographics
NPI:1508119843
Name:HALLMAN, TABATHA O (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TABATHA
Middle Name:O
Last Name:HALLMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TABATHA
Other - Middle Name:
Other - Last Name:OVERSTREET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1167 SPRATLIN PARK DRIVE
Mailing Address - Street 2:POB 9054
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-9054
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3644
Practice Address - Street 1:426 EAST G STREET
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643
Practice Address - Country:US
Practice Address - Phone:423-547-5950
Practice Address - Fax:423-467-3644
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC92741041C0700X
TN5956104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical