Provider Demographics
NPI:1548292782
Name:TIGHE, CAROLYN FOSTER (EDD,LMFT,LPC)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:FOSTER
Last Name:TIGHE
Suffix:
Gender:F
Credentials:EDD,LMFT,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12725 MCMANUS BLVD
Mailing Address - Street 2:BLDG 2 SUITE G
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4402
Mailing Address - Country:US
Mailing Address - Phone:757-874-1676
Mailing Address - Fax:757-874-2226
Practice Address - Street 1:12725 MCMANUS BLVD
Practice Address - Street 2:BLDG 2 SUITE G
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4402
Practice Address - Country:US
Practice Address - Phone:757-874-1676
Practice Address - Fax:757-874-2226
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717000076106H00000X
VA0701000517101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
133084OtherTRICARE
VA56207OtherANTHEM
VA5400911Medicaid