Provider Demographics
NPI:1437338423
Name:LINZY, TISHA (LCSW/LISW)
Entity Type:Individual
Prefix:
First Name:TISHA
Middle Name:
Last Name:LINZY
Suffix:
Gender:F
Credentials:LCSW/LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 TIGER BLVD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-1687
Mailing Address - Country:US
Mailing Address - Phone:812-537-7239
Mailing Address - Fax:
Practice Address - Street 1:403 BIELBY RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1003
Practice Address - Country:US
Practice Address - Phone:812-537-7230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1041C0700X
OH1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical