Provider Demographics
NPI:1891088506
Name:BRANDON, TAMMI L (MC, LPC, LIAC)
Entity type:Individual
Prefix:
First Name:TAMMI
Middle Name:L
Last Name:BRANDON
Suffix:
Gender:F
Credentials:MC, LPC, LIAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COLLEGE WAY
Mailing Address - Street 2:
Mailing Address - City:FRYEBURG
Mailing Address - State:ME
Mailing Address - Zip Code:04037-4678
Mailing Address - Country:US
Mailing Address - Phone:602-430-1882
Mailing Address - Fax:
Practice Address - Street 1:3 COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:FRYEBURG
Practice Address - State:ME
Practice Address - Zip Code:04037-4678
Practice Address - Country:US
Practice Address - Phone:602-430-1882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-27
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-12381101YP2500X
AZLIAC-11695101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)