Provider Demographics
NPI:1740451707
Name:TARTASKY, LEONA MARY (MSW)
Entity type:Individual
Prefix:
First Name:LEONA
Middle Name:MARY
Last Name:TARTASKY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:LEONA
Other - Middle Name:MARY
Other - Last Name:HIRTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8131 GOV RITCHIE HWY
Mailing Address - Street 2:STE G
Mailing Address - City:PASADENA
Mailing Address - State:MD
Mailing Address - Zip Code:21122-6940
Mailing Address - Country:US
Mailing Address - Phone:443-923-1886
Mailing Address - Fax:443-923-1895
Practice Address - Street 1:707 N BROADWAY
Practice Address - Street 2:KENNEDY KRIEGER INSTITUTE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1832
Practice Address - Country:US
Practice Address - Phone:443-923-9200
Practice Address - Fax:443-923-9405
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical