Provider Demographics
NPI:1154766145
Name:FIELDS, TANIKA L B (LPC)
Entity type:Individual
Prefix:MS
First Name:TANIKA
Middle Name:L B
Last Name:FIELDS
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 SHEA CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4557
Mailing Address - Country:US
Mailing Address - Phone:864-326-4380
Mailing Address - Fax:
Practice Address - Street 1:500 PETTIGRU ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3117
Practice Address - Country:US
Practice Address - Phone:864-907-8852
Practice Address - Fax:864-686-8371
Is Sole Proprietor?:No
Enumeration Date:2013-05-03
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
SC7250101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC2183Medicaid