Provider Demographics
NPI:1902170293
Name:IVEY, TAMEIKA LASHOUN (LPC, CPCS, CMAC, NCC)
Entity type:Individual
Prefix:MRS
First Name:TAMEIKA
Middle Name:LASHOUN
Last Name:IVEY
Suffix:
Gender:F
Credentials:LPC, CPCS, CMAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HARLEM
Mailing Address - State:GA
Mailing Address - Zip Code:30814-4908
Mailing Address - Country:US
Mailing Address - Phone:706-986-9357
Mailing Address - Fax:
Practice Address - Street 1:3643 WALTON WAY EXT
Practice Address - Street 2:BUILDING 4
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-4507
Practice Address - Country:US
Practice Address - Phone:706-364-1404
Practice Address - Fax:706-364-1419
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-04
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional