Provider Demographics
NPI:1386357747
Name:PINSON, TIFFANY (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:PINSON
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:PINSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SOCIAL WORKER
Mailing Address - Street 1:41800 HAYES RD STE 208
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1876
Mailing Address - Country:US
Mailing Address - Phone:586-203-2170
Mailing Address - Fax:888-910-9922
Practice Address - Street 1:34290 FORD RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3051
Practice Address - Country:US
Practice Address - Phone:313-978-3869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851116007101YM0800X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker