Ta'Shema Nicole Odoms, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3332 Issued in CT

Practice address

469 Buckland Rd Ste 104
South Windsor, CT 06074-3737

Phone

(860) 878-1696

Fax

(860) 432-4540

NPI assigned

Jan 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lynn Obomalayat, LLC

  • Social Worker
  • South Windsor, CT
  • NPI 1790327492
  NPD (past)

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1821552084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 WEST ST APT 20",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060662936",
            "telephone_number": "860-878-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 BUCKLAND RD STE 104",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743737",
            "telephone_number": "860-878-1696",
            "fax_number": "860-432-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOMS",
        "first_name": "TA'SHEMA",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Nunes, RD
• Scott Michael O'Brien, PA-C
• Jessica Obey, PT, DPT
• OBGYN Group of Eastern Connecticut, P.C.
• Lynn Marie Obomalayat, LCSW
• Jean Carol Ohliger, APRN
• Nicholas Ojeda
• Emily A Olson, OTR/L
• Orthopedic Accociates of Hartford,PC
• Orthopedic Accociates of Hartford,PC

• Professional Counselor in South Windsor, CT
• Providers in South Windsor, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.