Provider Demographics
NPI:1356420426
Name:TARKINGTON, W HENRY (LCSW, LCAS)
Entity type:Individual
Prefix:MR
First Name:W
Middle Name:HENRY
Last Name:TARKINGTON
Suffix:
Gender:M
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 E SIX FORKS RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7745
Mailing Address - Country:US
Mailing Address - Phone:919-833-8899
Mailing Address - Fax:919-833-4485
Practice Address - Street 1:211 E SIX FORKS RD
Practice Address - Street 2:SUITE 117
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7745
Practice Address - Country:US
Practice Address - Phone:919-833-8899
Practice Address - Fax:919-833-4485
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCSW 004681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical