Provider Demographics
NPI:1730784299
Name:SIZEMORE, TATIANNA TANEISA DENAE (LCSW-A, LCAS-A)
Entity type:Individual
Prefix:
First Name:TATIANNA
Middle Name:TANEISA DENAE
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:LCSW-A, LCAS-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 5TH AVE E
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-4377
Mailing Address - Country:US
Mailing Address - Phone:828-692-4289
Mailing Address - Fax:828-696-1794
Practice Address - Street 1:2579 CHIMNEY ROCK RD
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-9181
Practice Address - Country:US
Practice Address - Phone:828-692-4289
Practice Address - Fax:828-696-1794
Is Sole Proprietor?:No
Enumeration Date:2020-12-02
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0153561041C0700X
NCLCAS-26413101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)