Provider Demographics
NPI:1407009939
Name:TYRELL-WILLIAMS, TASHA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TASHA
Middle Name:
Last Name:TYRELL-WILLIAMS
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 1:44 COURT ST STE 1217
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4410
Mailing Address - Country:US
Mailing Address - Phone:718-957-1038
Mailing Address - Fax:718-957-1039
Practice Address - Street 1:300 CADMAN PLZ W
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3229
Practice Address - Country:US
Practice Address - Phone:718-957-1038
Practice Address - Fax:718-957-1039
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2023-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0769911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical