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NPI Code Detail

MEDICARE: TAMMY JO RODGERS LCSW

MEDICARE: TAMMY JO RODGERS LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker44SC06197500NJ
21041C0700XClinical Social WorkerCW022765PA

General Provider Information

NPI Number : 1043768468
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY JO RODGERS LCSW
Provider Business Mailing Address
First Line : 228 PARK AVE S
Second Line :
City : NEW YORK
State : NY
Zip : 10003-1502
Country : US
Telephone Number : 267-999-9534
Fax Number :
Provider Business Practice Location Address
First Line : 100 S JUNIPER ST FL 3
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-1316
Country : US
Telephone Number : 267-999-9534
Fax Number : 833-613-2680
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2016
Last Update Date : 07/12/2023

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Directions to “ TAMMY JO RODGERS LCSW” Practice Location

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