Provider Demographics
NPI:1982014254
Name:BESHEARS, TIFFANY (LPC-S, BC-TMH)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:BESHEARS
Suffix:
Gender:F
Credentials:LPC-S, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9950 WESTPARK DR STE 304
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5199
Mailing Address - Country:US
Mailing Address - Phone:832-409-6629
Mailing Address - Fax:833-513-0976
Practice Address - Street 1:9950 WESTPARK DR STE 304
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5199
Practice Address - Country:US
Practice Address - Phone:832-409-6629
Practice Address - Fax:833-513-0976
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-07
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 251B00000X, 251S00000X
LA4413101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health