Provider Demographics
NPI:1386141976
Name:BROWN, TIFFANY N (LCSW)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:BROWN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 N HILLS DR APT O
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-2884
Mailing Address - Country:US
Mailing Address - Phone:252-885-4622
Mailing Address - Fax:
Practice Address - Street 1:3012 FALSTAFF RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1813
Practice Address - Country:US
Practice Address - Phone:919-615-1027
Practice Address - Fax:919-615-1501
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-10
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0109091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical