Provider Demographics
NPI:1225730211
Name:EADDY, TUNISHA (LMSW)
Entity Type:Individual
Prefix:
First Name:TUNISHA
Middle Name:
Last Name:EADDY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9037 PARSONS BLVD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-6032
Mailing Address - Country:US
Mailing Address - Phone:718-553-3809
Mailing Address - Fax:718-553-3851
Practice Address - Street 1:9037 PARSONS BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-6032
Practice Address - Country:US
Practice Address - Phone:718-553-3809
Practice Address - Fax:718-553-3851
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1192681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical