Provider Demographics
NPI:1124436928
Name:TAMARAH STASCHIAK SERVICES, LLC
Entity type:Organization
Organization Name:TAMARAH STASCHIAK SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STASCHIAK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:410-562-5491
Mailing Address - Street 1:1431 DENNY RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-2521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:251 CLOVER RD
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-7739
Practice Address - Country:US
Practice Address - Phone:803-687-1584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2014-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5625251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health