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General NPI Number Information
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NPI Number | 1851429088
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Entity Type | Individual
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Provider Name | LELIA ANNE TANKERSLEY L.C.S.W.-C.
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 22 LINWOOD AVE
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City | BEL AIR
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State | MD
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Zip | 21014-3951
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Country | US
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Telephone | 410-877-3245
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Fax | 410-877-3245
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Provider Business Mailing Address
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Address Line | 2808 FALLSMONT DR
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City | FALLSTON
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State | MD
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Zip | 21047-2247
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Country | US
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Telephone | 410-879-6432
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 04667
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License Number State | MD
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