Provider Demographics
NPI:1366737223
Name:TAYLOR, TIFFANY MARIA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4579 S COBB DR SE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-6999
Mailing Address - Country:US
Mailing Address - Phone:678-838-8333
Mailing Address - Fax:678-838-8444
Practice Address - Street 1:4579 S COBB DR SE
Practice Address - Street 2:SUITE 600
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6999
Practice Address - Country:US
Practice Address - Phone:678-838-8333
Practice Address - Fax:678-838-8444
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0044471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical