Provider Demographics
NPI:1467112524
Name:NORWOOD, TEKISHA MITCHELL (LCSW)
Entity Type:Individual
Prefix:
First Name:TEKISHA
Middle Name:MITCHELL
Last Name:NORWOOD
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 1:208 URBANA OAKS WAY
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-6334
Mailing Address - Country:US
Mailing Address - Phone:601-325-0299
Mailing Address - Fax:
Practice Address - Street 1:208 URBANA OAKS WAY
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-6334
Practice Address - Country:US
Practice Address - Phone:601-325-0299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0078421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical