Provider Demographics
NPI:1861766610
Name:TSUTSUMI, ANTONIA CHANTAL (MSW, LCSW-C)
Entity type:Individual
Prefix:
First Name:ANTONIA
Middle Name:CHANTAL
Last Name:TSUTSUMI
Suffix:
Gender:F
Credentials:MSW, LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 39TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-1244
Mailing Address - Country:US
Mailing Address - Phone:703-861-9667
Mailing Address - Fax:
Practice Address - Street 1:1398 LAMBERTON DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-3414
Practice Address - Country:US
Practice Address - Phone:301-896-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-25
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD182181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical