Provider Demographics
NPI:1710783618
Name:OZERI, TIDHAR SHLOMO (LCSW)
Entity type:Individual
Prefix:
First Name:TIDHAR
Middle Name:SHLOMO
Last Name:OZERI
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 S COLUMBUS BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-4138
Mailing Address - Country:US
Mailing Address - Phone:520-481-8073
Mailing Address - Fax:
Practice Address - Street 1:360 S COLUMBUS BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-4138
Practice Address - Country:US
Practice Address - Phone:520-481-8073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ228151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical