Individual provider Active NPI

Tamara L Siders, LPC

  • Professional Counselor
  • Greenville, SC
National Provider Identifier
1720322399
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5470 Issued in SC
Practice address
301 Anderson St
Greenville, SC 29601-4022
Phone
(864) 283-0637
Fax
(864) 283-0638
NPI assigned
Nov 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5470 SC Primary

Addresses

Primary practice location

301 Anderson St
Greenville, SC 29601-4022

Mailing address

325 Marble LN
Boiling Springs, SC 29316-7437
Phone (864) 508-2105

Other identifiers 1

IdentifierTypeStateIssuer
GP4982MedicaidSC

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5470SCMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1720322399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 MARBLE LN",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293167437",
            "telephone_number": "864-508-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ANDERSON ST",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296014022",
            "telephone_number": "864-283-0637",
            "fax_number": "864-283-0638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDERS",
        "first_name": "TAMARA",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "5470",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4982",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.