Tammika Banks
Individual provider Active NPI Counselor · San Tan Valley, AZ
NPI 1154730422 · NPPES record last updated Feb 17, 2024
Key facts
- NPI
- 1154730422
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 4103 E Mica Rd
San Tan Valley, AZ 85143-5639 - Phone
- (602) 312-9816
- NPI assigned
- Aug 12, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luca Counseling and Wellness Center LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | |||
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
4103 E Mica Rd
San Tan Valley, AZ 85143-5639
Mailing address
4103 E Mica Rd
San Tan Valley, AZ 85143-5639
Phone (602) 312-9816
Other providers in San Tan Valley, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.