Provider Demographics
NPI:1699057612
Name:HARWOOD, TIFFANY MAY (LCSW)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:MAY
Last Name:HARWOOD
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 1:25 E ST STE 200
Mailing Address - Street 2:
Mailing Address - City:JBPHH
Mailing Address - State:HI
Mailing Address - Zip Code:96853-5400
Mailing Address - Country:US
Mailing Address - Phone:505-710-6789
Mailing Address - Fax:
Practice Address - Street 1:750 SIGNER BLVD
Practice Address - Street 2:BLDG 554
Practice Address - City:JBPHH
Practice Address - State:HI
Practice Address - Zip Code:96853
Practice Address - Country:US
Practice Address - Phone:808-220-2941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-076961041C0700X
NMC-090781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical