Provider Demographics
NPI:1821360280
Name:TOLBERT TOWNSEND, TARA NITA (LCSW)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:NITA
Last Name:TOLBERT TOWNSEND
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:NITA
Other - Last Name:TOLBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 BORDEAUX LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-2865
Mailing Address - Country:US
Mailing Address - Phone:912-484-9590
Mailing Address - Fax:912-307-3942
Practice Address - Street 1:109 BORDEAUX LN
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-2865
Practice Address - Country:US
Practice Address - Phone:912-376-9952
Practice Address - Fax:912-307-3942
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0041341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GACSW004134OtherSTATE LICENSE