Provider Demographics
NPI:1982703906
Name:KIRBY, TAMMY DARLENE (LPC)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:DARLENE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7277 HANOVER GREEN DR
Mailing Address - Street 2:SUITE A-2
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-1764
Mailing Address - Country:US
Mailing Address - Phone:804-730-9660
Mailing Address - Fax:804-569-7722
Practice Address - Street 1:7277 HANOVER GREEN DR
Practice Address - Street 2:SUITE A-2
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-1764
Practice Address - Country:US
Practice Address - Phone:804-730-9660
Practice Address - Fax:804-569-7722
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003071101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010066646Medicaid
VA088865MOtherSENTARA
VA455602000OtherMAGELLAN
VA115902OtherANTHEM
VA501508OtherVALUE OPTIONS
VA2116251OtherCIGNA
VA7275302OtherAETNA