Provider Demographics
NPI:1073098703
Name:TSAMASIROS, GEORGIA ELENI (LMSW, MPA)
Entity Type:Individual
Prefix:
First Name:GEORGIA
Middle Name:ELENI
Last Name:TSAMASIROS
Suffix:
Gender:F
Credentials:LMSW, MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BEACH 124TH ST APT 2K
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1858
Mailing Address - Country:US
Mailing Address - Phone:917-681-6311
Mailing Address - Fax:
Practice Address - Street 1:125 BEACH 124TH ST APT 2K
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-1858
Practice Address - Country:US
Practice Address - Phone:917-681-6311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-28
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104786104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker