Gibran Tatum, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

C1801524 Issued in OH

Practice address

1590 Crestview Dr
Ashland, OH 44805-3560

Phone

(419) 289-0970

NPI assigned

Oct 17, 2014

Last updated

Apr 21, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1982008074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 CRESTVIEW DR",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448053560",
            "telephone_number": "419-289-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1590 CRESTVIEW DR",
            "city": "ASHLAND",
            "state": "OH",
            "postal_code": "448053560",
            "telephone_number": "419-289-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATUM",
        "first_name": "GIBRAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-17",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "080696",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "C1801524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristie Eileen Taffin
• Mark A Taffin
• Jessica Tager, LISW
• Makayla Faith Tarkenton
• Hannah Alexandra Tateel
• Mehrdad Tavallaee, MD
• Brooke Ann Taylor, LSW
• Jennifer L Taylor
• Sadie P Taylor
• Tiffany Nicole Taylor

• Professional Counselor in Ashland, OH
• Providers in Ashland, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.