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General NPI Number Information
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NPI Number | 1285846709
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Entity Type | Individual
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Provider Name | EVANGELINE HARRIS TIERNEY MSW -LICSW
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1301 CONNECTICUT AVE. NW 750
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City | WASHINGTON
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State | DC
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Zip | 20036
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Country | US
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Telephone | 202-429-4935
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Fax | 202-429-0102
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Provider Business Mailing Address
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Address Line | 3167 WESTOVER DR.
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City | WASHINGTON
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State | DC
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Zip | 20020
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Country | US
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Telephone | 202-575-3270
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC302383
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License Number State | DC
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