Provider Demographics
NPI:1881993186
Name:MARGESON, TAMMY FAITH (LPCA, LCASA)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:FAITH
Last Name:MARGESON
Suffix:
Gender:F
Credentials:LPCA, LCASA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5954
Mailing Address - Country:US
Mailing Address - Phone:252-438-4145
Mailing Address - Fax:252-438-6405
Practice Address - Street 1:402 N MAIN ST, CREEDMOOR
Practice Address - Street 2:
Practice Address - City:CREEDMOOR
Practice Address - State:NC
Practice Address - Zip Code:27533
Practice Address - Country:US
Practice Address - Phone:919-529-2724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA10717101YP2500X
NC20075101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3994Medicaid