Provider Demographics
NPI:1528766474
Name:DJ TOMLIN CONSULTING PLLC
Entity type:Organization
Organization Name:DJ TOMLIN CONSULTING PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:JONES
Authorized Official - Last Name:TOMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:704-774-7249
Mailing Address - Street 1:PO BOX 42102
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-0002
Mailing Address - Country:US
Mailing Address - Phone:704-774-7249
Mailing Address - Fax:
Practice Address - Street 1:9711 DAVID TAYLOR DR STE 143
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-2366
Practice Address - Country:US
Practice Address - Phone:704-774-7249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DJ TOMLIN CONSULTING PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-02-20
Last Update Date:2024-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty