Provider Demographics
NPI:1538742218
Name:MCKEEHAN, TIFFINEY L (LCSW)
Entity type:Individual
Prefix:
First Name:TIFFINEY
Middle Name:L
Last Name:MCKEEHAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 8TH AVENUE
Mailing Address - Street 2:P.O. BOX 8
Mailing Address - City:METLAKATLA
Mailing Address - State:AK
Mailing Address - Zip Code:99926
Mailing Address - Country:US
Mailing Address - Phone:907-886-6911
Mailing Address - Fax:907-886-6917
Practice Address - Street 1:1271 8TH AVENUE
Practice Address - Street 2:
Practice Address - City:METLAKATLA
Practice Address - State:AK
Practice Address - Zip Code:99926
Practice Address - Country:US
Practice Address - Phone:907-886-6911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-30
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1520161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical