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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