Provider Demographics
NPI:1699868190
Name:KNOB, TASHA PETROPOULOS (LCSW)
Entity type:Individual
Prefix:MS
First Name:TASHA
Middle Name:PETROPOULOS
Last Name:KNOB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:TASHA
Other - Middle Name:P
Other - Last Name:DECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1012 CHILDS AVE
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4028
Mailing Address - Country:US
Mailing Address - Phone:484-332-0978
Mailing Address - Fax:
Practice Address - Street 1:1012 CHILDS AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4028
Practice Address - Country:US
Practice Address - Phone:484-332-0978
Practice Address - Fax:484-452-6080
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0136841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical