Provider Demographics
NPI:1184343402
Name:STEEN, TAMARIE MAURENE (LMHC)
Entity type:Individual
Prefix:MRS
First Name:TAMARIE
Middle Name:MAURENE
Last Name:STEEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:TAMARIE
Other - Middle Name:MAURENE
Other - Last Name:BRADLEY-SULLIVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 480645
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5305
Mailing Address - Country:US
Mailing Address - Phone:321-262-8178
Mailing Address - Fax:
Practice Address - Street 1:1011 SKIPJACK LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-4899
Practice Address - Country:US
Practice Address - Phone:321-262-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH16721101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty