Provider Demographics
NPI:1457984395
Name:DAY, TAMMY LYNN (LCSW-S, LCDC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:DAY
Suffix:
Gender:F
Credentials:LCSW-S, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1284
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-5284
Mailing Address - Country:US
Mailing Address - Phone:254-444-3691
Mailing Address - Fax:
Practice Address - Street 1:111 N WALL ST UNIT 1284
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-0128
Practice Address - Country:US
Practice Address - Phone:254-444-3691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12895101YA0400X
TX535381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX53538OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES
TX12895OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES