Provider Demographics
NPI:1316285356
Name:WORKLEY, TAMMY L (LCSW)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:L
Last Name:WORKLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:NJ
Mailing Address - Zip Code:08065-1709
Mailing Address - Country:US
Mailing Address - Phone:609-792-5720
Mailing Address - Fax:
Practice Address - Street 1:909 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:NJ
Practice Address - Zip Code:08065-0109
Practice Address - Country:US
Practice Address - Phone:856-905-3732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054523001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1316285356OtherOTHER