Provider Demographics
NPI:1780987933
Name:GOMES, TANYA (CSW)
Entity type:Individual
Prefix:MS
First Name:TANYA
Middle Name:
Last Name:GOMES
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 PEACHTREE ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-987-7160
Mailing Address - Fax:
Practice Address - Street 1:3855 PRESIDENTIAL PKWY
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-3705
Practice Address - Country:US
Practice Address - Phone:770-451-6838
Practice Address - Fax:770-451-7804
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical