Tamara Michelle Gaines
Individual provider Active NPI Counselor · Greenwille, SC
NPI 1740448976 · NPPES record last updated Aug 22, 2008
Key facts
- NPI
- 1740448976
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 124 Mallard St
Greenwille, SC 29601-4046 - Phone
- (864) 241-1040
- Fax
- (864) 241-1049
- NPI assigned
- May 23, 2008
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
124 Mallard St
Greenwille, SC 29601-4046
Mailing address
124 Mallard St
Greenwille, SC 29601-4046
Phone (864) 241-1040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 301100 | Medicaid | SC |
Other names
- Tamara Kennedy
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2008. 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.