TENDRA STATOM M.ED., LPC, NCC
NPI 1396330536
Counselor - Professional in Augusta, GA
Active since March 09, 2021
About Tendra Statom M.ed., Lpc, Ncc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TENDRA STATOM M.ED., LPC, NCC (NPI 1396330536) is an individual professional provider in Augusta, Georgia, licensed in Georgia (LPC012156) and active in the NPI registry since March 2021.
NPPES Registry Identity
NPI1396330536
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameTENDRA STATOMCredential: M.ED., LPC, NCC
Location Address3170 SKINNER MILL RD APT A6Augusta, GA 30909-5030
Mailing Address3170 Skinner Mill RdAugusta, GA 30909-5012 · (706) 309-0800
Phone(706) 319-7144
Sole ProprietorNo
Enumeration DateMarch 9, 2021
Last NPPES UpdateJune 6, 20223 updates tracked since enumeration
NPPES CertifiedMay 30, 2022
✔ NPI 1396330536 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
Licenses✔ Licensed in GA · LPC012156✔ Licensed in GA · APC006515
3170 SKINNER MILL RD APT A6, Augusta, GA 30909
Accepted Insurance
The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan, UnitedHealthcare.Insurance ›
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396330536, enumerated as an "individual" on March 09, 2021.
The provider is located at 3170 SKINNER MILL RD APT A6 AUGUSTA, GA 30909 and the phone number is (706) 319-7144.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
The provider might be accepting Accepts: Providence Health Plan and UnitedHealthcare. Please consult your insurance carrier or call the provider to verify.
