Provider Demographics
NPI:1386450666
Name:JONES, TIFFANY N (MBA MA, QMHP)
Entity type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:N
Last Name:JONES
Suffix:
Gender:F
Credentials:MBA MA, QMHP
Other - Prefix:MRS
Other - First Name:TIFFANY
Other - Middle Name:N
Other - Last Name:COLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1577 ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3576
Mailing Address - Country:US
Mailing Address - Phone:773-595-5168
Mailing Address - Fax:
Practice Address - Street 1:1577 ALBANY ST
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-3576
Practice Address - Country:US
Practice Address - Phone:773-595-5168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL4287995101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional