Provider Demographics
NPI:1841874427
Name:LAFELLA, TAMMY KAY (BSW)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:KAY
Last Name:LAFELLA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12919 TAMARACK DR
Mailing Address - Street 2:
Mailing Address - City:BURT
Mailing Address - State:MI
Mailing Address - Zip Code:48417-9428
Mailing Address - Country:US
Mailing Address - Phone:989-996-1112
Mailing Address - Fax:
Practice Address - Street 1:1040 W BRISTOL RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-5516
Practice Address - Country:US
Practice Address - Phone:810-257-3705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-10
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker