Healthcare Provider Details

I. General information

NPI: 1720719917
Provider Name (Legal Business Name): TESSA DROZDOWSKI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2022
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 MAIN ST STE 104
WHEELING WV
26003-2737
US

IV. Provider business mailing address

117 PARADISE LN APT 4
TONAWANDA NY
14150-2836
US

V. Phone/Fax

Practice location:
  • Phone: 304-513-3495
  • Fax:
Mailing address:
  • Phone: 716-510-0224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number114319
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberDP00947126
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: