Tanner, Terrance Neil

Tanner, Terrance Neil is an individual health care provider with primary practice located at 5314 Lincolnway E , Mishawaka IN 46544-4249. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Tanner, Terrance Neil can be contacted via phone (574) 256-9032.

Contact Information

Primary practice address
5314 Lincolnway E Mishawaka IN 46544-4249
Phone: (574) 256-9032
Fax: (574) 256-9049
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 1041C0700X Indiana

Profile Details

NPI number 1477552313
LBN Legal business name Tanner, Terrance Neil
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Mar 17th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477552313 NPPES
Indiana Other P01672681 RR MEDICARE
Indiana MEDICAID 300006930 RR MEDICARE
Indiana Other 000000282686 RR MEDICARE
Indiana Other 000000856457 RR MEDICARE

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