Provider Demographics
NPI:1700141595
Name:TSIGE, TIRUWORK TAKELE (LCSW)
Entity type:Individual
Prefix:MS
First Name:TIRUWORK
Middle Name:TAKELE
Last Name:TSIGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 CASTRO ST
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-1616
Mailing Address - Country:US
Mailing Address - Phone:415-515-4987
Mailing Address - Fax:
Practice Address - Street 1:1014 CASTRO ST
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-1616
Practice Address - Country:US
Practice Address - Phone:415-515-4987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW745981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical