Tasha Carpenter, MSW, LISW

Individual provider Active NPI Clinical Social Worker · Sidney, OH

NPI 1922465145 · NPPES record last updated Jan 19, 2016

Key facts

NPI
1922465145
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
I1501088 (OH)
Practice address
128 N Main Ave
Sidney, OH 45365-2731
Phone
(937) 710-4616
Fax
(937) 710-4732
NPI assigned
Jan 19, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
I1501088OHMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I1501088 OH Yes

Addresses

Primary practice location

128 N Main Ave
Sidney, OH 45365-2731

Mailing address

128 N Main Ave
Sidney, OH 45365-2731
Phone (937) 710-4616

Other providers in Sidney, OH

All providers in Sidney, OH · Clinical Social Worker in Ohio

Sources for this page

Verify at the official NPI Registry.