Provider Demographics
NPI:1386079929
Name:INCE, TAMARA (LICSW)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:INCE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 K ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1631
Mailing Address - Country:US
Mailing Address - Phone:202-553-8325
Mailing Address - Fax:888-551-5262
Practice Address - Street 1:1717 RHODE ISLAND AVE STE 620
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:833-968-8255
Practice Address - Fax:888-551-5262
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD156431041C0700X
VA09040085511041C0700X
DCLC500799051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical