Provider Demographics
NPI:1982919544
Name:TRUDEAU, TIFFANIE MONIQUE (LPC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:TIFFANIE
Middle Name:MONIQUE
Last Name:TRUDEAU
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7145 TURNER RD STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-5723
Mailing Address - Country:US
Mailing Address - Phone:321-720-3444
Mailing Address - Fax:
Practice Address - Street 1:7145 TURNER RD STE 102
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-5723
Practice Address - Country:US
Practice Address - Phone:321-720-3444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-08
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14185101YM0800X
VA0701006175101YP2500X
FLMH13469101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional