EBONIE MARIE TENNISON CDP
NPI 1578048062
Counselor - Addiction (Substance Use Disorder) in Tacoma, WA

Q: What is Ebonie Tennison's NPI number?

The NPI number for Ebonie Tennison is 1578048062. It was assigned to this individual provider in the NPPES registry on October 1, 2018. The provider is also known as Ebonie Marie Clark.

Q: What is Ebonie Tennison's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Ebonie Tennison was last updated on October 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 01, 2018

3101 S TACOMA WAY, TACOMA, WA 98409(253) 396-5800 Get Directions Write a Review

NPPES record last updated: October 18, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 18, 2021, Aug 21, 2020, Oct 1, 2018 (3 updates tracked since 2018).

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About Ebonie Marie Tennison Cdp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBONIE MARIE TENNISON CDP (NPI 1578048062) is an individual addiction (substance use disorder) provider in Tacoma, Washington, licensed in Washington (61011133) and active in the NPI registry since October 2018. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1578048062

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameEBONIE MARIE TENNISONCredential: CDP

Location Address3101 S TACOMA WAYTacoma, WA 98409-4717

Mailing Address6700 Martin Way E Ste 117Olympia, WA 98516-5586 · (360) 413-6910

Phone(253) 396-5800

Sole ProprietorNo

Enumeration DateOctober 1, 2018

Last NPPES UpdateOctober 18, 20213 updates tracked since enumeration

NPPES CertifiedOctober 18, 2021

✔ NPI 1578048062 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in WA · 61011133

3101 S TACOMA WAY, Tacoma, WA 98409

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Other Names 1

Former Name (1)Ebonie Marie Clark

Secondary Practice Locations 2

Location 16700 Martin Way E Ste 117Olympia, WA 98516-5586 · Phone (360) 413-6910

Location 23800 3rd St SEPuyallup, WA 98374-1109 · Phone (253) 200-0415 ext. 148

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebonie Tennison's NPI number?

The NPI number for Ebonie Tennison is 1578048062. It was assigned to this individual provider in the NPPES registry on October 1, 2018. The provider is also known as Ebonie Marie Clark.

Where is Ebonie Tennison located?

Ebonie Tennison practices at 3101 S Tacoma Way, Tacoma, WA 98409. The listed phone number is (253) 396-5800.

What is Ebonie Tennison's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Ebonie Tennison was last updated on October 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.