Tayyibah H Chase, MFT

Individual provider Active NPI Marriage & Family Therapist · Beltsville, MD

NPI 1447775473 · NPPES record last updated May 9, 2024

Key facts

NPI
1447775473
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
125127 (CA)
Practice address
11720 Beltsville Dr Ste 500
Beltsville, MD 20705-3139
Phone
(408) 462-1537
NPI assigned
Aug 10, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
125127CAMDMarriage & Family Therapist
101491CAMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 101491 CA
Student in an Organized Health Care Education/Training Program 390200000X 101491 CA
Marriage & Family Therapist 106H00000X 125127 CA Yes

Addresses

Primary practice location

11720 Beltsville Dr Ste 500
Beltsville, MD 20705-3139

Mailing address

26081 Mocine Ave
Hayward, CA 94544-2923
Phone (510) 881-5921

Other practice location 1

2275 Arlington Dr
San Leandro, CA 94578-1132
Phone (510) 317-1444

Other practice location 2

1319 Fruitvale Ave
Oakland, CA 94601-2927
Phone (510) 881-5921

Other practice location 3

26081 Mocine Ave
Hayward, CA 94544-2923
Phone (510) 881-5925

Other providers in Beltsville, MD

All providers in Beltsville, MD · Marriage & Family Therapist in Maryland

Sources for this page

Verify at the official NPI Registry.