Provider Demographics
NPI:1437959558
Name:FEBUS, TAMARA SADE (LPCA)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:SADE
Last Name:FEBUS
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 NEW HAVEN AVE UNIT 3
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-2164
Mailing Address - Country:US
Mailing Address - Phone:475-243-9379
Mailing Address - Fax:
Practice Address - Street 1:1549 FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06605-1935
Practice Address - Country:US
Practice Address - Phone:203-366-5817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8022101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional