Provider Demographics
NPI:1134700388
Name:TOMLINSON, STACIE ELIZABETH (MSW, LSW)
Entity Type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:ELIZABETH
Last Name:TOMLINSON
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 OFFSHORE RD
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-8114
Mailing Address - Country:US
Mailing Address - Phone:732-575-5409
Mailing Address - Fax:
Practice Address - Street 1:107 OFFSHORE RD
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-8114
Practice Address - Country:US
Practice Address - Phone:732-575-5409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05750500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker