Healthcare Provider Details

I. General information

NPI: 1538045299
Provider Name (Legal Business Name): MARSHALL TINGLER LMSW
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: EMILY TINGLER

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10470 QUEENS BLVD STE 200
FOREST HILLS NY
11375-3694
US

IV. Provider business mailing address

129 N 6TH ST # 2
BROOKLYN NY
11249-3201
US

V. Phone/Fax

Practice location:
  • Phone: 888-272-9355
  • Fax:
Mailing address:
  • Phone: 812-558-4440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: