Tammy Eidson, LISW, MSW, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I.1700020 Issued in OH

Practice address

55 Township Road 508 E
South Point, OH 45680-7276

Phone

(740) 377-2712

Fax

(740) 377-2588

NPI assigned

Mar 22, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489708800000",
    "number": "1396107173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 N 5TH ST",
            "city": "IRONTON",
            "state": "OH",
            "postal_code": "456381578",
            "telephone_number": "740-532-4858",
            "fax_number": "740-532-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 TOWNSHIP ROAD 508 E",
            "city": "SOUTH POINT",
            "state": "OH",
            "postal_code": "456807276",
            "telephone_number": "740-377-2712",
            "fax_number": "740-377-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDSON",
        "first_name": "TAMMY",
        "credential": "LISW, MSW, LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2017-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1201580",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1700020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OHIO LICENSE",
            "identifier": "I1700020",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Dillon
• Makenzie Disbennet, CDCA
• Christopher Dixon
• Danielle Doss, BSW, LSW
• Ashley Ann Edwards
• Robert Michael Eldridge
• Jeremy Ellis, CDCA
• Jennifer Lynn Ellsworth
• Kimberly Ermalovich, FNP
• Bridget Evans, CMS

• Social Worker in South Point, OH
• Providers in South Point, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.