Provider Demographics
NPI:1700633245
Name:GARFINKEL, TILLIE CAROL
Entity type:Individual
Prefix:MS
First Name:TILLIE
Middle Name:CAROL
Last Name:GARFINKEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 CRADOCK ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-4204
Mailing Address - Country:US
Mailing Address - Phone:301-384-4513
Mailing Address - Fax:
Practice Address - Street 1:1920 CRADOCK ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-4204
Practice Address - Country:US
Practice Address - Phone:301-384-4513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG50082026104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker