Provider Demographics
NPI:1053448654
Name:SCHLESSINGER NIJHAWAN, TAMARA IRIS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:IRIS
Last Name:SCHLESSINGER NIJHAWAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53726
Mailing Address - Country:US
Mailing Address - Phone:608-255-0669
Mailing Address - Fax:608-255-0667
Practice Address - Street 1:14 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53726
Practice Address - Country:US
Practice Address - Phone:608-255-0669
Practice Address - Fax:608-255-0667
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1393123104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39594200Medicaid