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NPI Code Detail

MEDICARE: MS. TANISHA CORPORAL LCSW

MEDICARE: MS. TANISHA CORPORAL LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW010152GA

General Provider Information

NPI Number : 1013849900
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TANISHA CORPORAL LCSW
Provider Business Mailing Address
First Line : 352 UNIVERSITY AVE SW UNIT S108
Second Line :
City : ATLANTA
State : GA
Zip : 30310-3619
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 352 UNIVERSITY AVE SW UNIT S108
Second Line :
City : ATLANTA
State : GA
Zip : 30310-3619
Country : US
Telephone Number : 404-277-1629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “ MS. TANISHA CORPORAL LCSW” Practice Location

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