Provider Demographics
NPI:1992504237
Name:TINEH, ASEAL (LSW)
Entity type:Individual
Prefix:
First Name:ASEAL
Middle Name:
Last Name:TINEH
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10801 S HARLEM AVE APT 2S
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-1161
Mailing Address - Country:US
Mailing Address - Phone:708-743-9011
Mailing Address - Fax:
Practice Address - Street 1:9721 165TH ST STE 21
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-4511
Practice Address - Country:US
Practice Address - Phone:708-671-8946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.1163221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical