Provider Demographics
NPI:1467577569
Name:HAGAR, TAMARA S (MA, LLP, LMFT, CAADC)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:S
Last Name:HAGAR
Suffix:
Gender:F
Credentials:MA, LLP, LMFT, CAADC
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:SH
Other - Last Name:PAPANIKOLAOU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LLP, TLMFT, CAC
Mailing Address - Street 1:27085 GRATIOT AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-2984
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27085 GRATIOT AVE STE 101
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-2984
Practice Address - Country:US
Practice Address - Phone:248-548-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL973558103TA0400X, 103TC0700X, 103TC1900X, 103TC2200X, 103TF0000X, 103TP2701X, 103T00000X
MIL1041877106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist