Provider Demographics
NPI:1386325132
Name:CARTHEN, TIFFANY (LCSWA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:CARTHEN
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 SAMUEL ADAMS CIR SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-0131
Mailing Address - Country:US
Mailing Address - Phone:170-488-4507
Mailing Address - Fax:
Practice Address - Street 1:409 SAMUEL ADAMS CIR SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-0131
Practice Address - Country:US
Practice Address - Phone:170-488-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0188501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical