Ta Mara's Promise, LLC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0710102326 Issued in VA

Legal business name

TA MARA'S PROMISE, LLC

Practice address

2601 West Ave
Ste: 201
Newport, VA 23607

Phone

(618) 204-0190

Fax

(757) 223-8100

NPI assigned

Jan 12, 2017

Last updated

Jan 12, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tamara Patrice Williams, LPC, MAC,CSAC

Title

Owner/Ceo

Phone

(757) 748-4048

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484179200000",
    "number": "1790221802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 WEST AVE",
            "address_2": "STE: 201",
            "city": "NEWPORT",
            "state": "VA",
            "postal_code": "23607",
            "telephone_number": "618-204-0190",
            "fax_number": "757-223-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 WEST AVE",
            "address_2": "STE: 201",
            "city": "NEWPORT",
            "state": "VA",
            "postal_code": "23607",
            "telephone_number": "618-204-0190",
            "fax_number": "757-223-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TA MARA'S PROMISE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "757-748-4048",
        "authorized_official_credential": "LPC, MAC,CSAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102326",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "070105823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Ann Brown
• Jane Reynolds Gilbert, COTA/L
• Newport Volunteer Rescue Squad, Inc

• Addiction (Substance Use Disorder) Counselor in Newport, VA
• Providers in Newport, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.