TAMIKA L. MATLOCK (NPI# 1003321357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003321357 |
| Entity Type | Individual |
| Full Name | TAMIKA L. MATLOCK |
| Credential | BSW, LPC |
| Practice Address |
1025 E Forest Ave Detroit MI 48207-1024 |
| Mailing Address |
812 Lothrop Rd Detroit MI 48202-2736 |
| Practice Telephone | 3136646814 |
| Practice Fax Number | 3138335973 |
| Mailing Telephone | 3138026546 |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2017-12-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | 6401010407 | MI | Behavioral Health & Social Service Providers |
| N | 104100000X | Social Worker | 6802076257 | MI | Behavioral Health & Social Service Providers |
| Street Address |
1025 E FOREST AVE |
| City | DETROIT |
| State | MI |
| Zip Code | 48207-1024 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114144847 | County of Wayne | Community/Behavioral Health | 1025 E Forest Ave, Building C, Detroit, MI 48207-1024 | 2007-04-20 |
| 1740891498 | Leathe Dantzler | Psychologist | 1025 E Forest Ave, Detroit, MI 48207-1098 | 2020-08-14 |
| 1790309334 | Wendy Sue Lawson | Social Worker | 1025 E Forest Ave, Detroit, MI 48207-1024 | 2020-05-29 |
| 1265075253 | Ian J Moore | Psychologist | 1025 E Forest Ave, Detroit, MI 48207-1024 | 2019-10-22 |
| 1124661459 | Safaa Issawi | Psychologist | 1025 E Forest Ave, Detroit, MI 48207-1024 | 2019-10-18 |
| 1154830503 | Latoya Taylor | Psychologist | 1025 E Forest Ave, Bldg C Room 216, Detroit, MI 48207 | 2017-09-28 |
| 1063950715 | Ahmar Zaman | Psychologist | 1025 E Forest Ave, Detroit, MI 48207-1024 | 2017-02-02 |
| 1043752124 | Jochebed Swilley | Social Worker | 1025 E Forest Ave, Detroit, MI 48207-1024 | 2016-11-07 |
| 1407216468 | Ruth Smith | Social Worker | 1025 E Forest Ave, Detroit, MI 48207-1024 | 2016-03-03 |
| 1083074538 | Shaundrea Whiting | Social Worker | 1025 E Forest Ave, Detroit, MI 48207-1024 | 2016-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245848506 | Anton R Gonzales | Physical Therapy Assistant | 2295 Chene, Detroit, Mi 48207, Detroit, MI 48207 | 2020-07-22 |
| 1033733928 | Taleshia Moss | Occupational Therapist | 2295 Chene, Detroit, MI 48207 | 2020-06-05 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1649831439 | Charday Penick | Social Worker | Team Wellness, 2925 Russell St, Detroit, MI 48207 | 2019-06-24 |
| 1568023349 | Alphia Ramona Burgess | Social Worker | Team Wellness Center, 2925 Russell Street, Detroit, MI 48207 | 2019-06-24 |
| 1447741608 | Sherice Ward | Social Worker | 100 River Place Drive, Ste 250, Detroit, MI 48207 | 2018-05-23 |
| 1427549955 | Mission Point of Detroit, LLC | Skilled Nursing Facility | 2102 Orleans, Detroit, MI 48207 | 2018-05-21 |
| 1043723737 | Olivia Carter | Case Management | 2712 Gratiot, Detroit, MI 48207 | 2017-11-16 |
| 1558885590 | Kalimah Johnson | Social Worker | 701 Mcdougall, Detroit, MI 48207 | 2017-08-01 |
| 1922534692 | Angela Young | Social Worker | 100 River Place 520, Detroit, MI 48207 | 2017-05-02 |
| Find all providers in zip 48207 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143046 | Comforting Adult Services LLC | Counselor | 14559 Monica St, Detroit, MI 48238-1953 | 2020-01-18 |
| 1235779406 | Jacqueline Yvetter Smith Davis | Counselor | 16609 Archdale St, Detroit, MI 48235-3416 | 2020-01-15 |
| 1033767843 | Shawn Alecia Mccoy | Counselor | 3600 3rd St Apt 1004, Detroit, MI 48201-2337 | 2019-08-27 |
| 1013472745 | Shyfirska Emery | Counselor | 13700 Linnhurst St, Detroit, MI 48205-2885 | 2019-02-06 |
| 1871060368 | Taia Sardinas | Counselor | 7251 E Congress St Apt 307, Detroit, MI 48214-2395 | 2018-11-01 |
| 1639668387 | Debora Lynn Howard | Counselor | 17200 Rowe St, Detroit, MI 48205-3120 | 2018-05-08 |
| 1932698669 | Alexis J Terry | Counselor | 5555 Conner St Ste 2210, Detroit, MI 48213-3496 | 2018-05-08 |
| 1245739614 | Chavela Bryant | Counselor | 18659 Griggs St, Detroit, MI 48221-1907 | 2018-02-12 |
| 1962901835 | Kendra Sibert | Counselor | 5112 Beaubien St, Detroit, MI 48202-4107 | 2018-02-06 |
| 1649787714 | Katrina Frazier | Counselor | 19968 Hubbell St, Detroit, MI 48235-1603 | 2018-01-10 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.