1124514757 NPI number — MR. RALPH ANDREW TAMAYO LPA

Table of content: MR. RALPH ANDREW TAMAYO LPA (NPI 1124514757)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124514757 NPI number — MR. RALPH ANDREW TAMAYO LPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAMAYO
Provider First Name:
RALPH
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LPA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TAMAYO
Provider Other First Name:
RALPH ANDREW ROMAN
Provider Other Middle Name:
BERMEJO
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSYD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1124514757
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/06/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WEST COUNSELING, 2324 CONCORD LAKE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CONCORD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28025-6936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-337-8618
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2324 CONCORD LAKE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONCORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28025-2814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-829-1343
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/06/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TH0100X , with the licence number:  5370 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: 5370 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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