1912913781 NPI number — MS. TAMMY J RAKOCZY MSW, LISW-S

Table of content: MS. TAMMY J RAKOCZY MSW, LISW-S (NPI 1912913781)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912913781 NPI number — MS. TAMMY J RAKOCZY MSW, LISW-S

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAKOCZY
Provider First Name:
TAMMY
Provider Middle Name:
J
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MSW, LISW-S
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAMSEY
Provider Other First Name:
TAMMY
Provider Other Middle Name:
J.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW, LSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1912913781
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7993 MULBERRY RD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT PERRY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43760
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
740-787-2899
Provider Business Mailing Address Fax Number:
740-788-3401

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2112 CHERRY VALLEY RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-787-2899
Provider Business Practice Location Address Fax Number:
740-788-3401
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  S-0032172 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X , with the licence number: I.0700229 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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