Provider Demographics
NPI:1932861499
Name:HOWERTON, TIFFANY IRENE (LCMHC, LCAS)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:IRENE
Last Name:HOWERTON
Suffix:
Gender:F
Credentials:LCMHC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5932 QUERCUS COVE CT APT 308
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28217-0195
Mailing Address - Country:US
Mailing Address - Phone:336-602-8116
Mailing Address - Fax:
Practice Address - Street 1:5700 EXECUTIVE CENTER DR STE 200
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-8833
Practice Address - Country:US
Practice Address - Phone:704-494-7796
Practice Address - Fax:704-494-7799
Is Sole Proprietor?:No
Enumeration Date:2021-10-12
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16885101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC16885OtherLCMHC LICENSE