Provider Demographics
NPI:1023421302
Name:PAWLAK, TAMMY (LMFT)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:PAWLAK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37110-2682
Mailing Address - Country:US
Mailing Address - Phone:931-386-6300
Mailing Address - Fax:931-386-6301
Practice Address - Street 1:101 W MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:TN
Practice Address - Zip Code:37110-2682
Practice Address - Country:US
Practice Address - Phone:931-386-6300
Practice Address - Fax:931-386-6301
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2031106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1023421302OtherNPI
TN1396496790OtherNPI 2 GROUP
TNQ071472Medicaid