Tamala K Disney, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2405418 Issued in OH

Practice address

2713 Central Ave
Liberty Township, OH 45044-4851

Phone

(937) 902-4219

NPI assigned

Jul 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Overcomers Counseling Services LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Middletown, OH
  • NPI 1447082656
  NPD Authorized official

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

{
    "created_epoch": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1740766211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 CENTRAL AVE",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450444851",
            "telephone_number": "937-902-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 CENTRAL AVE",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450444851",
            "telephone_number": "937-902-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISNEY",
        "first_name": "TAMALA",
        "middle_name": "K",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S1440345",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.1440345",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2405418",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Davis
• Jennifer Demos-Bertrand, D.O
• Diane Marie Dew, RDN, LD
• Dialysis Access Center of Cincinnati, Inc.
• Discover Your Path, LLC
• Joseph Dollenmeyer
• Kristan Renee Dooley, LPC
• Armand Patrick Douandji Noulaye
• Megan Dreyer, LPCC
• Sarah Dugan

• Clinical Social Worker in Liberty Township, OH
• Providers in Liberty Township, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.