Provider Demographics
NPI:1730774977
Name:EASLEY, TAHIRA LASHEA (LSW)
Entity type:Individual
Prefix:
First Name:TAHIRA
Middle Name:LASHEA
Last Name:EASLEY
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3692 ROXMORE CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-3613
Mailing Address - Country:US
Mailing Address - Phone:614-327-9491
Mailing Address - Fax:
Practice Address - Street 1:175 S 3RD ST STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5194
Practice Address - Country:US
Practice Address - Phone:614-484-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.1101334104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker