Provider Demographics
NPI:1699973982
Name:EISERMAN, TIFFANY (LPC)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:
Last Name:EISERMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 MCCRAREN RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2715
Mailing Address - Country:US
Mailing Address - Phone:847-642-7734
Mailing Address - Fax:
Practice Address - Street 1:1530 MCCRAREN RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2715
Practice Address - Country:US
Practice Address - Phone:847-642-7734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional