Provider Demographics
NPI:1609148071
Name:PATTERSON, TAMARA (LMHC)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:FL
Mailing Address - Zip Code:32768-0144
Mailing Address - Country:US
Mailing Address - Phone:689-247-3806
Mailing Address - Fax:
Practice Address - Street 1:2575 SAGE CREEK PL
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-6446
Practice Address - Country:US
Practice Address - Phone:689-247-3806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-01
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health