Provider Demographics
NPI:1558044610
Name:NEMETH, TAMMY WAINE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:WAINE
Last Name:NEMETH
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 1:224 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARTINTON
Mailing Address - State:IL
Mailing Address - Zip Code:60951-6142
Mailing Address - Country:US
Mailing Address - Phone:815-428-7308
Mailing Address - Fax:
Practice Address - Street 1:224 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARTINTON
Practice Address - State:IL
Practice Address - Zip Code:60951-6142
Practice Address - Country:US
Practice Address - Phone:815-428-7308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0254951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical