Provider Demographics
NPI:1710979786
Name:TUOHY, JANET KIM FEMINO (LCSW-S)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:KIM FEMINO
Last Name:TUOHY
Suffix:
Gender:F
Credentials:LCSW-S
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:KIM-FEMINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78627-0306
Mailing Address - Country:US
Mailing Address - Phone:512-368-1715
Mailing Address - Fax:
Practice Address - Street 1:102 W MORROW ST
Practice Address - Street 2:SUITE 202
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-4307
Practice Address - Country:US
Practice Address - Phone:512-368-1715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558301041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC803228Medicare ID - Type Unspecified
Q52201Medicare UPIN