Provider Demographics
NPI:1912913781
Name:RAKOCZY, TAMMY J (MSW, LISW-S)
Entity Type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:J
Last Name:RAKOCZY
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:J
Other - Last Name:RAMSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:7993 MULBERRY RD.
Mailing Address - Street 2:
Mailing Address - City:MOUNT PERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43760
Mailing Address - Country:US
Mailing Address - Phone:740-787-2899
Mailing Address - Fax:740-788-3401
Practice Address - Street 1:2112 CHERRY VALLEY RD
Practice Address - Street 2:SUITE C
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055
Practice Address - Country:US
Practice Address - Phone:740-787-2899
Practice Address - Fax:740-788-3401
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS-00321721041C0700X
OHI.0700229104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical