Provider Demographics
NPI:1861995458
Name:COVER, TAMMY J (LPC)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:J
Last Name:COVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27218 AZALEA CT
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-2940
Mailing Address - Country:US
Mailing Address - Phone:480-512-1613
Mailing Address - Fax:
Practice Address - Street 1:27218 AZALEA CT
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-2940
Practice Address - Country:US
Practice Address - Phone:832-534-3624
Practice Address - Fax:832-610-3472
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-09
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX74960101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4131716-01Medicaid