Provider Demographics
NPI:1073687943
Name:VORHIS, NOEMI TASHA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NOEMI
Middle Name:TASHA
Last Name:VORHIS
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:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:TN
Mailing Address - Zip Code:38455-0058
Mailing Address - Country:US
Mailing Address - Phone:256-434-1256
Mailing Address - Fax:
Practice Address - Street 1:175 MAIN ST.
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:TN
Practice Address - Zip Code:38455-0058
Practice Address - Country:US
Practice Address - Phone:256-434-1256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASTERS101YM0800X
AL3643C1041C0700X
TNLCSW66491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051530957OtherBCBS OF AL PROVIDER #
AL102I801670Medicare PIN