Provider Demographics
NPI:1538574983
Name:BEANE, TIFFANY (MSW)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:BEANE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 EDMONDSON AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-1600
Mailing Address - Country:US
Mailing Address - Phone:443-873-9389
Mailing Address - Fax:443-438-5820
Practice Address - Street 1:4200 EDMONDSON AVE STE 102
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-1600
Practice Address - Country:US
Practice Address - Phone:443-873-9389
Practice Address - Fax:443-438-5820
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker