Provider Demographics
NPI:1750160271
Name:SARGENT, TAMMY MARIE (CADC)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:MARIE
Last Name:SARGENT
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 BAYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6993
Mailing Address - Country:US
Mailing Address - Phone:207-210-5452
Mailing Address - Fax:207-847-2017
Practice Address - Street 1:70 BAYVIEW ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6993
Practice Address - Country:US
Practice Address - Phone:207-847-2017
Practice Address - Fax:207-847-2017
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECAC7979101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)