Tashema Durn

Individual provider Active NPI Mental Health Counselor · Camilla, GA

NPI 1578992152 · NPPES record last updated Nov 7, 2013

Key facts

NPI
1578992152
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
218 S Macarthur Dr
Camilla, GA 31730-7410
Phone
(229) 336-2247
Fax
(229) 336-8009
NPI assigned
Nov 5, 2013
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

218 S Macarthur Dr
Camilla, GA 31730-7410

Mailing address

218 S Macarthur Dr
Camilla, GA 31730-7410
Phone (229) 336-2247

Other providers in Camilla, GA

All providers in Camilla, GA · Mental Health Counselor in Georgia

Sources for this page

Verify at the official NPI Registry.