Provider Demographics
NPI:1295531119
Name:O'ROURKE, TAMMY (LCSW-C)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:O'ROURKE
Suffix:
Gender:
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9315 EDISTRO PL
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-4446
Mailing Address - Country:US
Mailing Address - Phone:301-452-1653
Mailing Address - Fax:
Practice Address - Street 1:9315 EDISTRO PL
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-4446
Practice Address - Country:US
Practice Address - Phone:301-452-1653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD114021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical