Provider Demographics
NPI:1427703974
Name:BAIN, TAMIKA N
Entity type:Individual
Prefix:MRS
First Name:TAMIKA
Middle Name:N
Last Name:BAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-1227
Mailing Address - Country:US
Mailing Address - Phone:336-362-6588
Mailing Address - Fax:
Practice Address - Street 1:4045 PAYNE RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1227
Practice Address - Country:US
Practice Address - Phone:336-362-6588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health