Provider Demographics
NPI:1558725366
Name:JAMES, TAMMY LYNN (LCSW, LISW)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:JAMES
Suffix:
Gender:F
Credentials:LCSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 HAWKS CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-0026
Mailing Address - Country:US
Mailing Address - Phone:803-626-6200
Mailing Address - Fax:
Practice Address - Street 1:1808 SECOND BAXTER XING STE 208E
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708
Practice Address - Country:US
Practice Address - Phone:803-626-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-07
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSW.12751.CP1041C0700X
NCC0115181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical