Provider Demographics
NPI:1013489806
Name:CHAMBERS, TASHIA P (LICSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:TASHIA
Middle Name:P
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 PINEFIELD CT
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-3358
Mailing Address - Country:US
Mailing Address - Phone:240-888-1097
Mailing Address - Fax:
Practice Address - Street 1:4810 SAINT BARNABAS RD
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-4604
Practice Address - Country:US
Practice Address - Phone:301-541-0963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500797821041C0700X
MD157911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical