Provider Demographics
NPI:1578289922
Name:TICHLER, CAROL (CSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:TICHLER
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:TICHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CSW
Mailing Address - Street 1:1725 YORK AVE APT 32B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7892
Mailing Address - Country:US
Mailing Address - Phone:191-767-0752
Mailing Address - Fax:
Practice Address - Street 1:1725 YORK AVE APT 32B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-7892
Practice Address - Country:US
Practice Address - Phone:191-767-0752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY218611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical