Individual ProviderHawa Sitaha TandiaSocial WorkerBehavioral Health & Social Service ProvidersPractice Address5411 Mockingbird Dr Apt 315, Anchorage, AK 99507-1690(202) 417-7626(907) 212-6972PECOS EnrollmentBased on the most recent information from CMS, provider Hawa Sitaha Tandia does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:46 AM.Profile DetailsProvider ID1376138404Provider TypeIndividualFull NameTandia, Hawa SitahaCredentialLMSWGenderFemaleSole ProprietorYesEnumeration Date3/1/2021Last Updated1/9/2024Contact InformationPractice LocationPractice Address5411 Mockingbird Dr Apt 315, Anchorage, AK 99507-1690Phone(202) 417-7626FaxUnlisted FaxMailing LocationMailing AddressProvidence Health Systems Breakthrough, 3760 Piper Street, Anchorage, AK 99508Phone(907) 212-6972FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense158419AlaskaCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense25448MarylandCode104100000XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense25448MarylandCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense158419AlaskaProvider IdentifiersIDDescriptionIssuerID16103950DescriptionOtherIssuerCAQH