Provider Demographics
NPI:1932752219
Name:ARCHER, TAMIKA M (LPC-R)
Entity Type:Individual
Prefix:MRS
First Name:TAMIKA
Middle Name:M
Last Name:ARCHER
Suffix:
Gender:F
Credentials:LPC-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10621 JONES ST STE 201B
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7511
Mailing Address - Country:US
Mailing Address - Phone:703-688-2904
Mailing Address - Fax:
Practice Address - Street 1:10621 JONES ST STE 201B
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7511
Practice Address - Country:US
Practice Address - Phone:703-688-2904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor