Healthcare Provider Details

I. General information

NPI: 1427251156
Provider Name (Legal Business Name): CHA-TANYA L LANKFORD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 FOREST ST
DOVER DE
19904-3418
US

IV. Provider business mailing address

46 RIVERSIDE RD
DOVER DE
19904-5725
US

V. Phone/Fax

Practice location:
  • Phone: 302-677-1590
  • Fax: 302-677-1591
Mailing address:
  • Phone: 302-736-6762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0000847
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50078015
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberG10063
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: