Provider Demographics
NPI:1407997448
Name:TSONIS, EILEEN (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:
Last Name:TSONIS
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MS
Other - First Name:EILEEN
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:44 CHAMPIONSHIP CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5440
Mailing Address - Country:US
Mailing Address - Phone:410-902-8851
Mailing Address - Fax:
Practice Address - Street 1:44 CHAMPIONSHIP CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5440
Practice Address - Country:US
Practice Address - Phone:410-902-8851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD073361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD148185Medicare UPIN