Provider Demographics
NPI:1588072011
Name:LANZA, TIFFINI (LCSW, MED)
Entity type:Individual
Prefix:DR
First Name:TIFFINI
Middle Name:
Last Name:LANZA
Suffix:
Gender:F
Credentials:LCSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 EGYPT RD
Mailing Address - Street 2:#690
Mailing Address - City:OAKS
Mailing Address - State:PA
Mailing Address - Zip Code:19456
Mailing Address - Country:US
Mailing Address - Phone:215-859-0322
Mailing Address - Fax:
Practice Address - Street 1:1310 EYGPT RD
Practice Address - Street 2:#690
Practice Address - City:OAKS
Practice Address - State:PA
Practice Address - Zip Code:19456
Practice Address - Country:US
Practice Address - Phone:215-859-0322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-29
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW131548104100000X
PACW0201401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker