Organization
TA MARA'S PROMISE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA PATRICE WILLIAMS LPC, MAC,CSAC (OWNER/CEO)
(757) 748-4048
Entity
Organization
Contact information
Practice address
2601 WEST AVE, STE: 201, NEWPORT, VA 23607
(618) 204-0190
(757) 223-8100
Mailing address
2601 WEST AVE, STE: 201, NEWPORT, VA 23607
(618) 204-0190
(757) 223-8100
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102326
VA
101YM0800X
Mental Health Counselor
070105823
VA
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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