Provider Demographics
NPI:1861582082
Name:TARPLIN, AUDREY P (LICSW)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:P
Last Name:TARPLIN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:E FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-0441
Mailing Address - Country:US
Mailing Address - Phone:508-540-2353
Mailing Address - Fax:
Practice Address - Street 1:320 GIFFORD ST
Practice Address - Street 2:UNIT 2
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-5104
Practice Address - Country:US
Practice Address - Phone:508-540-2353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1074661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP06510Medicare ID - Type UnspecifiedPROVIDER NUMBER