Provider Demographics
NPI:1659077592
Name:TRANTHAM-TITTLE, ALISHA (LSW)
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:
Last Name:TRANTHAM-TITTLE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1229 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEARFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:16830-3305
Mailing Address - Country:US
Mailing Address - Phone:814-765-1045
Mailing Address - Fax:814-765-8489
Practice Address - Street 1:1229 S 2ND ST
Practice Address - Street 2:
Practice Address - City:CLEARFIELD
Practice Address - State:PA
Practice Address - Zip Code:16830-3305
Practice Address - Country:US
Practice Address - Phone:814-765-1045
Practice Address - Fax:814-765-8489
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW140433104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker