Provider Demographics
NPI:1164614947
Name:TANDON, USHA R (MS, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:USHA
Middle Name:R
Last Name:TANDON
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 RUTGERS AVE
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-1739
Mailing Address - Country:US
Mailing Address - Phone:610-328-5743
Mailing Address - Fax:
Practice Address - Street 1:110 PARK AVE
Practice Address - Street 2:#3
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-1736
Practice Address - Country:US
Practice Address - Phone:610-291-1704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC004642101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional