Provider Demographics
NPI:1831723717
Name:VILLINES, TAMYRA (LMHC)
Entity type:Individual
Prefix:
First Name:TAMYRA
Middle Name:
Last Name:VILLINES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5203 N DIXIE HWY APT A2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-4047
Mailing Address - Country:US
Mailing Address - Phone:954-470-3902
Mailing Address - Fax:
Practice Address - Street 1:5203 N DIXIE HWY APT A2
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-4047
Practice Address - Country:US
Practice Address - Phone:954-470-3902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-28
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17605101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health