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
| License | State | Type | Specialty |
|---|---|---|---|
| 125127 | CA | MD | Marriage & Family Therapist |
| 101491 | CA | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Allie Grace Chewning
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All providers in Beltsville, MD · Marriage & Family Therapist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 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.