Provider Demographics
NPI:1689953952
Name:SMALLWOOD, TAMMY L (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:L
Last Name:SMALLWOOD
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Gender:F
Credentials:LCSW
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Mailing Address - Street 1:2250 THUNDERSTICK DR
Mailing Address - Street 2:STE 1104
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-9009
Mailing Address - Country:US
Mailing Address - Phone:859-254-1035
Mailing Address - Fax:859-254-2075
Practice Address - Street 1:900 BEASLEY ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-4266
Practice Address - Country:US
Practice Address - Phone:859-254-1035
Practice Address - Fax:859-254-2075
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2022-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY62751041C0700X
KY39211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical