Provider Demographics
NPI:1801811260
Name:SHEFF, TINA MATARAZZO (LICSW)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MATARAZZO
Last Name:SHEFF
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:TINA
Other - Middle Name:
Other - Last Name:MATARAZZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:117 ELLENFIELD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905-4541
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:146 W RIVER ST FL 3
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-2609
Practice Address - Country:US
Practice Address - Phone:401-793-5700
Practice Address - Fax:401-793-7801
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW01227104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker