Provider Demographics
NPI:1225434384
Name:AVILUCEA, TIFFANIE (LMSW)
Entity type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:
Last Name:AVILUCEA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TIFFANIE
Other - Middle Name:
Other - Last Name:HINES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:530 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3440
Mailing Address - Country:US
Mailing Address - Phone:575-526-9878
Mailing Address - Fax:
Practice Address - Street 1:520 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001
Practice Address - Country:US
Practice Address - Phone:575-526-9878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-10995104100000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker