Healthcare Provider Details

I. General information

NPI: 1487629093
Provider Name (Legal Business Name): TANYA C INCK-FOLGER LISW-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2006
Last Update Date: 08/24/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11680 ROYALTON RD
NORTH ROYALTON OH
44133-4461
US

IV. Provider business mailing address

PO BOX 361431
STRONGSVILLE OH
44136-0055
US

V. Phone/Fax

Practice location:
  • Phone: 440-879-8806
  • Fax: 440-878-9897
Mailing address:
  • Phone: 440-878-8806
  • Fax: 440-878-9897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberI0007711
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: