Provider Demographics
NPI:1912913781
Name:RAKOCZY, TAMMY J (MSW, LISW-S)
Entity type:Individual
Prefix:MS
First Name:TAMMY
Middle Name:J
Last Name:RAKOCZY
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:MS
Other - First Name:TAMMY
Other - Middle Name:J
Other - Last Name:RAMSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:430 NEW PARK AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06110-1142
Mailing Address - Country:US
Mailing Address - Phone:844-866-8336
Mailing Address - Fax:
Practice Address - Street 1:25000 EUCLID AVE STE 305
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44117-2646
Practice Address - Country:US
Practice Address - Phone:844-866-8336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.07002291041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical