Provider Demographics
NPI:1053434886
Name:TIEGEL, STUART ALLEN (MSW)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:ALLEN
Last Name:TIEGEL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2324 W JOPPA RD STE 220
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4618
Mailing Address - Country:US
Mailing Address - Phone:410-583-2623
Mailing Address - Fax:410-583-2949
Practice Address - Street 1:2324 W JOPPA RD STE 220
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4618
Practice Address - Country:US
Practice Address - Phone:410-583-2623
Practice Address - Fax:410-583-2949
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD010941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical