Basic Information
Provider Information
NPI: 1194175570
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIGGS
FirstName: TAMMY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LPC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 11818
Address2:  
City: FORT SMITH
State: AR
PostalCode: 729171818
CountryCode: US
TelephoneNumber: 4794526650
FaxNumber: 4794525847
Practice Location
Address1: 3111 S 70TH ST
Address2:  
City: FORT SMITH
State: AR
PostalCode: 729035017
CountryCode: US
TelephoneNumber: 4794526650
FaxNumber: 4794525847
Other Information
ProviderEnumerationDate: 06/16/2016
LastUpdateDate: 01/06/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XA1712329ARN Behavioral Health & Social Service ProvidersCounselorMental Health
101YP2500XP2001150ARY Behavioral Health & Social Service ProvidersCounselorProfessional

No ID Information.


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