Provider Demographics
NPI:1063196020
Name:STRALEY, TIFFANY SARAH (LCSWA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:SARAH
Last Name:STRALEY
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 QUIET REFUGE LN
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-2891
Mailing Address - Country:US
Mailing Address - Phone:724-712-4176
Mailing Address - Fax:
Practice Address - Street 1:607 WICKER ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4151
Practice Address - Country:US
Practice Address - Phone:919-292-2614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0169851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical