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General NPI Number Information
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NPI Number | 1588873319
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Entity Type | Individual
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Provider Name | AIMEE DENISE TSIKITAS MSW,LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 COMMERCE PARK DR STE 110
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City | WILLIAMSPORT
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State | PA
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Zip | 17701-5475
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Country | US
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Telephone | 570-323-6944
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Fax | 570-323-4529
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Provider Business Mailing Address
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Address Line | 320 HIGHLAND DR
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City | MOUNTVILLE
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State | PA
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Zip | 17554-1232
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Country | US
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Telephone | 717-285-7121
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Fax | 717-285-2658
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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 | CW014406
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License Number State | PA
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