Provider Demographics
NPI:1578605739
Name:CHITWOOD, TAMI MICHELE (LPC,LADC,SAP)
Entity Type:Individual
Prefix:MS
First Name:TAMI
Middle Name:MICHELE
Last Name:CHITWOOD
Suffix:
Gender:F
Credentials:LPC,LADC,SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 W CHERRY AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-3318
Mailing Address - Country:US
Mailing Address - Phone:580-554-0608
Mailing Address - Fax:580-242-3888
Practice Address - Street 1:1021 W CHERRY AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-3318
Practice Address - Country:US
Practice Address - Phone:580-554-0608
Practice Address - Fax:580-242-3888
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2978101Y00000X
OK597101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)