Provider Demographics
NPI:1740473495
Name:PIERCE, TYREIS D (LCSW-C)
Entity type:Individual
Prefix:
First Name:TYREIS
Middle Name:D
Last Name:PIERCE
Suffix:
Gender:M
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 1:13908 BISHOPS BEQUEST RD
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-6946
Mailing Address - Country:US
Mailing Address - Phone:202-536-8053
Mailing Address - Fax:
Practice Address - Street 1:13908 BISHOPS BEQUEST RD
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-6946
Practice Address - Country:US
Practice Address - Phone:202-536-8053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD226811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical