Provider Demographics
NPI:1861957474
Name:TAMKUS, NATALIE SARA (LSW)
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:SARA
Last Name:TAMKUS
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 1:32 JUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17821-7951
Mailing Address - Country:US
Mailing Address - Phone:570-214-1686
Mailing Address - Fax:570-214-9260
Practice Address - Street 1:32 JUSTIN DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-7951
Practice Address - Country:US
Practice Address - Phone:570-214-1686
Practice Address - Fax:570-214-9260
Is Sole Proprietor?:No
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134276104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker