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Organization
MARTHA TIERNEY LCSW LLC
Active
Organization
MARTHA TIERNEY LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA T TIERNEY (PRESIDENT)
(612) 720-6136
Entity
Organization
Contact information
Practice address
2530 W IOWA ST, CHICAGO, IL 60622-7249
(555) 555-1212
Mailing address
2530 W IOWA ST, CHICAGO, IL 60622-7249
(555) 555-1212
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/20/2024
Last updated
10/15/2024
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