Provider Demographics
NPI:1841957735
Name:STOCKING, TAMMY L (LMSW)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:L
Last Name:STOCKING
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 MAIN ST STE 27A
Mailing Address - Street 2:
Mailing Address - City:WILLIMANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06226-1940
Mailing Address - Country:US
Mailing Address - Phone:475-455-8841
Mailing Address - Fax:
Practice Address - Street 1:1320 MAIN ST STE 27A
Practice Address - Street 2:
Practice Address - City:WILLIMANTIC
Practice Address - State:CT
Practice Address - Zip Code:06226-1940
Practice Address - Country:US
Practice Address - Phone:475-455-8841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-26
Last Update Date:2021-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4433104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker