Tabria Corprew
Individual provider Active NPI Professional Counselor · Pooler, GA
NPI 1700425964 · NPPES record last updated Jun 16, 2021
Key facts
- NPI
- 1700425964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC011310 (GA)
- Practice address
- 101 Blue Moon Crossing Ste. 3
Unit 114
Pooler, GA 31322 - Phone
- (912) 682-1383
- NPI assigned
- Jan 4, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| LPC011310 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Compassionate Counseling & Support Services, LLC | Current | Accepting new patients | |
| Teladoc Health Medical Group, P.a. | Professional | Current | Accepting new patients |
Locations
101 Blue Moon Xing
Ste 3
Pooler, GA 31322
Phone (912) 682-1383
Interoperability endpoints
- tabriajackson@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC011310 | GA | Yes |
Addresses
Primary practice location
101 Blue Moon Crossing Ste. 3
Unit 114
Pooler, GA 31322
Mailing address
101 Blue Moon Crossing
Suite 3, Unit 114
Pooler, GA 31322
Phone (912) 325-9855
Other practice location 1
5205 Addison Pl
Pooler, GA 31322-9482
Phone (912) 682-1383
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hello@compassionatecounseling.sprucecare.com | Direct |
Other providers in Pooler, GA
- Michele Cookieanos
- Gail Cooper-Hawthorne
- Eva Cooper
- Katrina Cooper
- Doris Kathleen Cope
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Costco Wholesale Corporation
- Costrini & Meadows, PC
- Costrini Sleep Services, Inc.
All providers in Pooler, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 16, 2021. 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.