Individual provider · Type 1 NPI

Kyle Justin Tam, BS

Counselor · Mattoon, IL

NPI number 1114697422 Active

Practice location

750 Broadway Ave E
Mattoon, IL 61938-4610

Call (217) 238-5700 Map

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XNone listed

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.

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About NPI 1114697422

Kyle Justin Tam, BS's National Provider Identifier is 1114697422, issued on Sep 17, 2021. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Mattoon, IL. The record was last updated on Sep 17, 2021.