Active NPI
Tamia Whiteside
- Behavior Technician
- Summerville, SC
National Provider Identifier
1962910216
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 17-35253
- Practice address
- 205 Ayers Cir
Summerville, SC 29485-3303 - Phone
- (843) 460-2605
- Fax
- (888) 298-0519
- NPI assigned
- Jan 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 17-35253 | SC | Primary |
Addresses
Primary practice location
205 Ayers Cir
Summerville, SC 29485-3303
Mailing address
181 W Professional Park CT Ste 1
Bowling Green, KY 42104-3250
Phone (270) 777-9283
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17-35253 | SC | MD | Behavior Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Building Independence Together | Past | Accepting new patients | |
| Community Living in Kentucky, LLC | Past | Accepting new patients | |
| Gateway Counseling Services | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Behavior Analyst
- Walterboro, SC
- NPI 1568906394
-
- Community/Behavioral Health Agency
- Murray, KY
- NPI 1518281419
-
- Community/Behavioral Health Agency
- Bowling Green, KY
- NPI 1508278458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785974400000",
"number": "1962910216",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 W PROFESSIONAL PARK CT STE 1",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "421043250",
"telephone_number": "270-777-9283",
"fax_number": "270-777-9283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 AYERS CIR",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294853303",
"telephone_number": "843-460-2605",
"fax_number": "888-298-0519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITESIDE",
"first_name": "TAMIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-19",
"last_updated": "2026-08-06",
"certification_date": "2026-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "SC",
"license": "17-35253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.