Provider Demographics
NPI:1487629093
Name:INCK-FOLGER, TANYA C (LISW-S)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:C
Last Name:INCK-FOLGER
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 361431
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-0055
Mailing Address - Country:US
Mailing Address - Phone:440-878-8806
Mailing Address - Fax:440-878-9897
Practice Address - Street 1:11680 ROYALTON RD
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-4461
Practice Address - Country:US
Practice Address - Phone:440-879-8806
Practice Address - Fax:440-878-9897
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-18
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00077111041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical