Provider Demographics
NPI:1851365183
Name:GILBERT, TAMMY ARTEGA (LPC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:ARTEGA
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 19TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79401-4832
Mailing Address - Country:US
Mailing Address - Phone:806-766-1172
Mailing Address - Fax:806-766-1286
Practice Address - Street 1:1628 19TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79401-4832
Practice Address - Country:US
Practice Address - Phone:806-766-1172
Practice Address - Fax:806-766-1286
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15364101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX028859901Medicaid