Provider Demographics
NPI:1841066750
Name:TAMAYA COUNSELING CENTER
Entity type:Organization
Organization Name:TAMAYA COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:YAMILETH
Authorized Official - Middle Name:MARTINEZ
Authorized Official - Last Name:OBANDO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:562-644-7684
Mailing Address - Street 1:132 W LAKE ST OFC 7
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1020
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 W LAKE ST OFC 7
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1020
Practice Address - Country:US
Practice Address - Phone:562-644-7684
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty