Provider Demographics
NPI:1811288780
Name:POPE, TAMMY LYNN (MS, ICGCII)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LYNN
Last Name:POPE
Suffix:
Gender:F
Credentials:MS, ICGCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7585 W ARKANSAS AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-5425
Mailing Address - Country:US
Mailing Address - Phone:303-947-8505
Mailing Address - Fax:
Practice Address - Street 1:7585 W ARKANSAS AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-5425
Practice Address - Country:US
Practice Address - Phone:402-419-8929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YA0400X, 101YP2500X, 172V00000X, 251B00000X
CONLC.0101894101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No172V00000XOther Service ProvidersCommunity Health Worker
No251B00000XAgenciesCase Management