Provider Demographics
NPI:1346574035
Name:KELLY, TIFFANY MARIE (MS, LMHC, NCC)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:MARIE
Last Name:KELLY
Suffix:
Gender:F
Credentials:MS, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 S ARTHUR ST STE 500
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-2260
Mailing Address - Country:US
Mailing Address - Phone:509-744-1117
Mailing Address - Fax:509-744-3055
Practice Address - Street 1:140 S ARTHUR ST STE 500
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-2260
Practice Address - Country:US
Practice Address - Phone:509-744-1117
Practice Address - Fax:509-744-3055
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60034712101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health