Provider Demographics
NPI:1417154485
Name:VAN HOLLANDER, TAMMI (LCSW, RPT)
Entity Type:Individual
Prefix:
First Name:TAMMI
Middle Name:
Last Name:VAN HOLLANDER
Suffix:
Gender:F
Credentials:LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 COULTER AVE
Mailing Address - Street 2:SUITE 213
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2427
Mailing Address - Country:US
Mailing Address - Phone:610-642-1144
Mailing Address - Fax:
Practice Address - Street 1:119 COULTER AVE
Practice Address - Street 2:SUITE 213
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2427
Practice Address - Country:US
Practice Address - Phone:610-642-1144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0139021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical