Provider Demographics
NPI:1164154142
Name:LEIMER, TAMMY J (LSW)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:J
Last Name:LEIMER
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 1:5704 SPRUCE MILL DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-7220
Mailing Address - Country:US
Mailing Address - Phone:215-630-7424
Mailing Address - Fax:
Practice Address - Street 1:5704 SPRUCE MILL DR
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7220
Practice Address - Country:US
Practice Address - Phone:215-630-7424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1274471041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000000000Medicaid