Provider Demographics
NPI:1215343157
Name:DIFABIO, TIZIANA (LCSW-C)
Entity type:Individual
Prefix:
First Name:TIZIANA
Middle Name:
Last Name:DIFABIO
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5268-G NICHOLSON LANE
Mailing Address - Street 2:SUITE 185
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1009
Mailing Address - Country:US
Mailing Address - Phone:240-428-8227
Mailing Address - Fax:301-434-4896
Practice Address - Street 1:13240 EXECUTIVE PARK TER
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2640
Practice Address - Country:US
Practice Address - Phone:240-428-8227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health