Provider Demographics
NPI:1881902765
Name:PEETE, TANYA RENEE (LCSW-C, LMSW)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:RENEE
Last Name:PEETE
Suffix:
Gender:F
Credentials:LCSW-C, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51134 FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2482
Mailing Address - Country:US
Mailing Address - Phone:248-805-2422
Mailing Address - Fax:
Practice Address - Street 1:2601 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-1817
Practice Address - Country:US
Practice Address - Phone:248-805-2422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2024-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical