Provider Demographics
NPI:1912644485
Name:IVEY, TASIA (MA, LPC, CRC, NCC)
Entity Type:Individual
Prefix:
First Name:TASIA
Middle Name:
Last Name:IVEY
Suffix:
Gender:F
Credentials:MA, LPC, CRC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8880 E SPEEDWAY BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1712
Mailing Address - Country:US
Mailing Address - Phone:520-329-1807
Mailing Address - Fax:
Practice Address - Street 1:8880 E SPEEDWAY BLVD STE 301
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-1712
Practice Address - Country:US
Practice Address - Phone:520-329-1807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional