Provider Demographics
NPI:1922288471
Name:ORLUK, TANDI L (MSSW,LCSW)
Entity Type:Individual
Prefix:MS
First Name:TANDI
Middle Name:L
Last Name:ORLUK
Suffix:
Gender:F
Credentials:MSSW,LCSW
Other - Prefix:MRS
Other - First Name:TANDI
Other - Middle Name:ROLPH
Other - Last Name:ORLUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:TANDI LYNN ROLPH
Mailing Address - Street 1:1101 VETERANS DR # 122-HPLD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2235
Mailing Address - Country:US
Mailing Address - Phone:859-233-4511
Mailing Address - Fax:859-281-3867
Practice Address - Street 1:1101 VETERANS DR # 122-HPLD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40502-2235
Practice Address - Country:US
Practice Address - Phone:859-233-4511
Practice Address - Fax:859-281-3867
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5271104100000X
KY3596104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30615058Medicaid