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Organization

TAVA CLINICAL SERVICES, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DALLEN ALLRED (TREASURER)
(801) 319-6471
Entity
Organization

Contact information

Practice address
1122 LADY ST STE 100, COLUMBIA, SC 29201-3469
(980) 949-0364
(801) 992-8269
Mailing address
1032 E BRANDON BLVD # 1542, BRANDON, FL 33511-5509

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
103T00000X
Psychologist
1041C0700X
Clinical Social Worker
Primary
106H00000X
Marriage & Family Therapist
2084P0800X
Psychiatry Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
04/22/2026
Last updated
04/22/2026
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