Provider Demographics
NPI:1982129854
Name:COMPTON, TAMMY MARTIN (LSW)
Entity Type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:MARTIN
Last Name:COMPTON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:695-J E. MORRILL AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207
Mailing Address - Country:US
Mailing Address - Phone:614-668-8524
Mailing Address - Fax:
Practice Address - Street 1:1455 S 4TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1011
Practice Address - Country:US
Practice Address - Phone:614-444-0800
Practice Address - Fax:614-744-8160
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2017-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS0901302171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator