Provider Demographics
NPI:1427128248
Name:SMITH, TIFFANY RENEE (LCSW-C)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:RENEE
Last Name:SMITH
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 NORTHWAY DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-7827
Mailing Address - Country:US
Mailing Address - Phone:410-426-0386
Mailing Address - Fax:
Practice Address - Street 1:3218 NORTHWAY DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-7827
Practice Address - Country:US
Practice Address - Phone:410-426-0386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker