Tammi Renee Ivy, MRC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

P0411049 Issued in AR

Practice address

3358 Suite D. S. 2ND Street
Cabot, AR 72023

Phone

(501) 286-6053

Fax

(870) 523-9301

NPI assigned

Dec 31, 2008

Last updated

Feb 21, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1104062868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 EDWARDS ST",
            "city": "NEWPORT",
            "state": "AR",
            "postal_code": "721129074",
            "telephone_number": "870-926-2840",
            "fax_number": "870-523-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3358 SUITE D. S. 2ND STREET",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "72023",
            "telephone_number": "501-286-6053",
            "fax_number": "870-523-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "TAMMI",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MRC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-31",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0411049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169387795",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Page Hunter
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• Brandon Lee Hutchison
• Iris Counseling, PLLC
• Judith Michelle Isaac, PHARMD
• Jordan Jackson, QBHP
• Sean Lawrence Jacobs-Gibson, LMSW
• Andrea Jakubec
• Jessica Lauren Jeffers, NURSE PRACTITIONER
• Jeffrey Kemper Pmhnp-BC PLLC

• Professional Counselor in Cabot, AR
• Providers in Cabot, AR by specialty
• Professional Counselor in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.