Doctor Name: | TINA TINSLEY |
NPI Number: | 1780738732 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | CSW001690 |
Business Practice Address: | 255 Chulitna Way Bogart, GA - 306225116 |
Business Phone Number: | 7707252667 |
Business Fax Number: | 7707250683 |
Mailing Address: | 255 Chulitna Way, BOGART |
State: | GA |
Postal Code: | 306225116 |
Phone Number: | 7707252667 |
Fax Number: | 7707250683 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CSW001690 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |