Provider Demographics
NPI:1285264689
Name:WITH T.
Entity type:Organization
Organization Name:WITH T.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MIHELISH
Authorized Official - Suffix:
Authorized Official - Credentials:MSC/CC
Authorized Official - Phone:520-461-8465
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:NOGALES
Mailing Address - State:AZ
Mailing Address - Zip Code:85628-0244
Mailing Address - Country:US
Mailing Address - Phone:520-461-8465
Mailing Address - Fax:
Practice Address - Street 1:1061 CAMINO CARALAMPI
Practice Address - Street 2:
Practice Address - City:RIO RICO
Practice Address - State:AZ
Practice Address - Zip Code:85648-1682
Practice Address - Country:US
Practice Address - Phone:520-461-8465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-24
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty